BACKGROUND Labour pain is one of the severe pains experienced by women. If severe and unrelieved, it may be deleterious to the mother and the fetus. Despite perceived social and cultural aversion to pain relief in labour, the majority of women want pain relief in labour. Epidural analgesia and opioid are the commonest labour analgesia. OBJECTIVES To compare the outcomes of labour in women who had epidural bupivacaine with those who were administered intravenous tramadol for pain relief in labour. METHODOLOGY This was a randomized controlled trial of 107 nulliparous women (53 of whom were given epidural bupivacaine and 54 were administered intravenous tramadol for labour analgesia). Ethical clearance was obtained from the research and ethics committee of the Federal Teaching Hospital, Gombe. Maternal and perinatal outcomes such as duration of labour, mode of delivery and Apgar scores of the newborns in the two groups were compared. Data were analyzed using statistical package for social science (SPSS) version 20. Independent sample T-test and Chi-square were used for continuous and categorical variables respectively. Pvalue ˂0.05 was cons