Background: Labor analgesia using epidural levobupivacaine has become very popular by virtue of its safety and lesser motor blockade. Adding opioids to local anesthetic drugs provide rapid onset and prolonged analgesia but may be associated with several maternal and fetal adverse effects. The purpose of this study is to compare fentanyl and tramadol used in epidural in terms of duration of analgesia and frequency of the adverse fetomaternal outcome. Materials and Methods: A total of 60 primipara patients with a singleton pregnancy in active labor were given epidural analgesia after randomly allocating them in two groups of 30 each. Group I received 10 ml 0.125% solution of levobupivacaine + 50 μg fentanyl. Group II received 50 mg tramadol instead of fentanyl. Epidural top ups were given when parturient complained of two painful contractions (visual analogue scale ≥ 4) with 3 ml of respective solution to each group. Data collected were demographic profile of the patients, analgesic qualities, side– effects and the fetomaternal outcome. Results: Patients in Group II had significantly prolonged analgesia (145 ± 9 minutes) than in Group I (95 ± 7 minutes). Patients receiving fentanyl showed rapid onset of analgesia, but there were more incidence of side–effects like shivering, pruritus, transient fetal bradycardia, hypotension, nausea and vomiting. Only side–effect in the tramadol group was nausea and vomiting. During labor, maternal satisfaction was excellent. Conclusions: Adding tramadol to local anesthetic provides prolonged analgesia with minimal side effects. Fentanyl, when used as adjuvant to local anesthetic, has a rapid onset of analgesia but has certain fetomaternal side–effects