To study the effectiveness of intrauterine anesthesia for pain relief during fractional curettage. Methods: A doubleblinded, randomized, placebo- controlled trial was conducted in 66 patients with abnormal uterine bleeding undergoing fractional curettage under paracervical block, using 10- mL 1% lidocaine plus intrauterine 5- mL 2% lidocaine (n = 33) or saline (n = 33). The primary outcome was the maximum pain score measured with a 10- cm visual analog scale. Other outcomes measured included pain profile, number of patients with pain score more than 4, each patient’ s global satisfaction index, adverse events, and serum lidocaine profile. Results: The 2 groups were comparable in age, body mass index, education, socioeconomic status, menopausal status, and parity. Compared with the saline group, the lidocaine group had a significantly lower median value for the maximum pain score (2.3 versus 4.7, P = .022) and fewer patients with a pain score more than 4 (33.3% versus 60.6% , P = .026). The pain scores were lower at the endocervical curettage and the uterine curettage steps. There was no difference between the 2 groups in other outcomes. The number needed to treat to prevent a case with a pain score more than 4 was 3.7 (95% confidence interval 2.4- 38.5). Conclusion: The addition of intrauterine anesthesia to paracervical block can further reduce pain during fractional curettage without increasing adverse effects. To study the effectiveness of intrauterine anesthesia for pain relief during fractional curettage. Methods: A doubleblinded, randomized, placebo-controlled trial was conducted in 66 patients with abnormal uterine bleeding undergoing fractional curetage under paracervical block, using 10- mL 1% lidocaine plus intrauterine The primary outcome was the maximum pain score measured with a 10- cm visual analog scale. The other outcomes measured included pain profile, number of patients with pain score (n = 33) Results: The 2 groups were comparable in age, body mass index, education, socioeconomic status, menopausal status, and parity. Compared with the saline group , the lidocaine group had a significantly lower median value for the maximum pain score (2.3 versus 4.7, P = .022) and fewer patients with a pain score more than 4 (33.3% versus 60.6%, P = .026). The number needed to treat to prevent a case with a pain score more than 4 was 3.7 (95% confidence interval 2.4-38.5). Conclusion: The addition of intrauterine anesthesia to paracervical block can further reduce pain during fractional curetage without increasing adverse effects.