Central venous access has become a mandatory part for clinical management of critically ill patients, both in acute care setting and chronic long term care. However, anatomical landmark guided technique for IJV cannualation is not devoid of complication like carotid arterial puncture and pneumothorax. In this prospective, randomized, controlled, clinical trial, we compared and assess the anatomical landmark guided technique for IJV cannulation with USG guided technique in terms of success rate, no. of attempts and complications. Sixty four patients of either sex, between age group of 18 –70 years requiring either elective or emergency CVC placement, were randomly divided to 2 groups, Group USG: USG guided technique and Group ALG: Conventional or anatomical landmark guided technique. Venous access time and catheterization time both were found to be statistically significantly less in USG group compared to ALG group (p<0.0001). Successful cannulation in 1st attempt could be done in more no. of patients in USG group (26 patients) compared to ALG group (6 patients) (p<0.00001). Success Rate was 87.5% in Group ALG while it was 100% in Group USG. Which was statistically highly significant (p<0.05). Overall Complications rate was 25% versus 3.125% in Group ALG and group USG respectively which was statistically significant.(p<0.05).Ultrasound guided central venous catheter placement is easy, safer and prudent approach than anatomical landmark guided technique hence should be encouraged to improve patient’s safety and quality care.