Objective: To evaluate intraperitoneal (IP) lidocaine administration and intravenous (IV) lidocaine infusion for postoperative pain control after cesarean section. Study design: prospective randomized, double-blind, placebo-controlled study. Patients and methods: Initially, 165 pregnant full-term females, indicated to be underwent elective cesarean delivery for various indications were randomized equally to either group C (control, IP and IV saline), group IP (intraperitoneal lidocaine administration), or group IV (intravenous lidocaine infusion).Five patients were excluded from each group for various reasons. The outcome measures were postoperative pain scoring, total pethidine consumption and the need for postoperative analgesia. Results: Significantly reduced visual analogue scale scores after 4h, total pethidine consumption in 24 hours, time of ambulation, onset of pain relief and the need for rescue analgesia in groups IV and IP compared with controls. Postoperative nausea and vomiting were less frequently noted in groups IP and IV than in group C, but this trend was not statistically significant. Conclusion: The IP lidocaine instillation and IV lidocaine infusion significantly reduced postoperative pain and opioid consumption in women underwent elective cesarean section, compared with control infusions.