Background: Circumcision of a male child is an integral part of some African cultures. It is the oldest surgical procedure performed worldwide. Its existence, indications, techniques and devices are shrouded in controversies. The techniques of neonatal circumcision are diverse and till date there is no conclusive evidence to suggest the best technique. An ideal technique of neonatal circumcision should be simple, safe and heal satisfactorily with good cosmetic appeal. Objectives: The objective of the study was to compare freehand, Plastibell and Gomco clamp techniques of circumcision in neonates in terms of wound healing, wound healing complications, cosmetic outcome and parental satisfaction with the outcome of the circumcision. Methods: This was a hospital based, prospective, randomized clinical study conducted at the Federal Medical Centre Lokoja, Kogi state, Nigeria, over a period of 6 months, after approval from the Ethics and Research Committee of the hospital. A total of 144 male neonates were recruited into the study. Using simple randomization technique, 48 neonates each were randomized into three study groups [Freehand (FH), Gomco (GM) and Plastibell (PB) groups]. Informed consent for the study and surgery was obtained from the parents. The neonates were circumcised according to the technique of circumcision corresponding to the group they were randomized into. All procedures were performed under local anaesthesia as day case. The patients were seen at the outpatient clinic post-operatively on the 3rd day, 7th day and 4th week. Wound healing was assessed on the 7th post-operative day. Satisfactory wound healing was defined in this study as the presence of a completely apposed wound edge with no exudate, scab or oedema. Cosmetic outcome of the three techniques and parental satisfaction with the outcome of the circumcision were assessed using a 4 and 5 points Likert scale respectively on the 4th post-operative week. Data obtained from the study were entered into the proforma designed for the study and were analyzed using SPSS version 21.0. P value was set at 0.05. Results: One hundred and forty-four neonates were recruited into the study at mean age of 15.26 ± 6.72days. The three groups were comparable in terms of age (p=0.207) and weight (p=0.098) at circumcision. The mean age for GM group was 14.08 ± 7.19 days, PB group; 15.17 ± 6.16 days and FH group; 16.52 ± 6.72 days. Indication for circumcision was sociocultural in 101(70.1%) patients, religious in 31(21.5%) and religious + socio-cultural in 12(8.4%) patients. The mean duration for Plastibell circumcision was significantly shorter (5.81 ± 0.84mins), than for Gomco circumcision (15.71 ± 1.68mins) and freehand circumcision (16.81 ±5.52mins), p= <0.0001. There was satisfactory wound healing in 48(100%) patients in GM group, compared to 47(97.8%) in FH group and 45(93.8%) in PB group (p=0.324). Wound healing complications were recorded in 7 patients, 1(2.1%) in FH group with wound infection, 5(10.4%) in PB group with moderate pain despite use of analgesia and 1(2.1%) patient with skin bridge in FH group. None in the GM group had any of these complications. The plastic surgeon rated cosmetic outcome as excellent in 47.9% of the patients in FH group, 43.8% of GM group and 12.5% of PB group. The parents however rated cosmetic outcome as excellent in 95.8% of FH group, 91.7% of GM and 85.4% of PB groups. A high level of satisfaction was expressed by 97.9% of parents in FH group, 91.7% in GM and 87.5% in PB groups. Conclusion: This study has shown that there is no significant difference in superficial wound healing amongst the three circumcision techniques. However healing was significantly complicated by undue pain in the Plastibell group. The cosmetic outcome of freehand circumcision was significantly better than that of Gomco and Plastibell circumcisions. On the basis of low late complication rate, better cosmetic outcome and higher level of parental satisfaction, freehand circumcision should be recommended to parents in hospitals where trained surgeons perform neonatal circumcision. KEY WORDS: Neonatal circumcision, wound healing, cosmetic outcome, three techniques