Background: Hip fractures usually occur following significant trauma in young population and trivial injury in elderly people. Presenting complaint in Emergency Department(ED) is pain which needs urgent management. There are various modalities suggested for relieving pain in patients with hip fractures which includes IV analgesia and more recently fascia iliaca compartment block (FICB).This prospective randomized trial was conducted to compare the outcome of pain management in patients with hip fractures (Neck of femur fracture, Intertrochanteric fracture, Sub trochanteric fracture) who received standard analgesia with or without FICB in ED. Materials & Methods: After institutional review board approval, 62 consecutive cases that presented to ED of tertiary referral centre with hip fractures were randomized in two groups with 31 patients in group A (cases) receiving FICB and standard analgesia (1gm paracetamol TDS and 2mg butorphanol BD) and standard analgesia only in group B (control). The results were compared in terms of VAS (Visual Analogue Scale) score at presentation and at 10 minutes, 2 hours and 8 hours of starting pain management protocol. Results: The mean age for case group was 66.90years (SD=14.132) and control group was 64.71years (SD=17.958) (p=0.595).40.3% were male and 59.6% were female (p=0.796). VAS for pain was significantly lower after standard analgesia plus FICB than standard analgesia alone at later stage (p value is 0.04 and 0.005 at 2 and 8 hours respectively). Conclusions: FICB with standard analgesia was found to be more effective measure in relieving pain in patients with hip fractures who presented at ED in this cohort.