Background and aim of the study: The rationale behind this study was to reduce the side effects of standard dose of tramadol by reducing the dose of tramadol and to achieve same analgesic effect by combining with diclofenac. So this study compares the analgesic efficacy and side effect profile of rectal tramadol 100 mg with combination of rectal tramadol 50 mg and rectal diclofenac 50 mg in patients undergoing lower abdominal surgeries. Materials and Methods: Two hours after the establishment of spinal anaesthesia, patient were administered either tramadol 100 mg rectally in Group T (n=50) or combination of tramadol 50 mg rectally and diclofenac 50 mg rectally in Group TD (n=50). Using 0-10 numeric rating scale (NRS), pain at the surgical site at rest during postoperative period was measured. Any side effects like nausea, vomiting, pruritus, dizziness, headache, drowsiness, gastritis, Sweating etc. for 24 h was noted. Results: The mean duration of effective postoperative analgesia was 314.5 ± 7 minutes and 318.9 ± 5 minutes in group T and TD respectively. The difference between the groups with respect to duration of effective postoperative analgesia was not statistically significant. Group T had a statistically higher incidence of nausea and vomiting than group TD. Conclusion: The combination of low dose tramadol and diclofenac may be a better alternative to standard dose tramadol as it provides same quality and duration of analgesia with fewer side effects.