BACKGROUND Blindness due to cataract presents an enormous problem in India, not just in terms of human morbidity but also in terms of economic loss and social burden. Cataract surgery constitutes by far the most common surgical procedure performed under local anaesthesia. Therefore, it is the need of the hour to make the anaesthetic technique painless and effective. OBJECTIVES To compare sub-tenon's anaesthesia and peribulbar anaesthesia with respect to pain/analgesia. METHODS This hospital based prospective study was conducted between December 2012 and May 2014 at Basaveshwar Teaching and General Hospital affiliated to M. R. Medical College, Gulbarga, Karnataka. During the above mentioned period, 200 randomly selected patients fulfilling the criteria framed were included for the study. They were randomly divided into group P (n=100), who underwent manual small incision cataract surgery under peribulbar anaesthesia and group S (n=100) patients underwent manual small incision cataract surgery by sub-tenon's anaesthesia. After the procedure the efficacy and safety of the two methods of anaesthesia in SICS with respect to intraoperative pain, akinesia, lid movements, rise in IOP and complications were compared. RESULTS Perioperative pain was dramatically lower in the sub-tenon's group of patients with significantly fewer patients experiencing unacceptable levels of pain. CONCLUSION Sub-tenon's anesthesia is recommended as a safe and effective alternative to peribulbar anaesthesia for small incision cataract surgery as it provides better analgesia. KEYWORDS Peribulbar Anaesthesia, Sub-tenon's Anaesthesia, Manual SICS.