Abstract : Mastalgia or Mastodynia is a common medical condition for which a patient seeks medical consultation both in primary care and surgical clinics. This study is an effort to study the role of Centchroman in the treatment of mastalgia catered in our institute as compared to Evening Primrose Oil (EPO) being used as first line treatment. This is an open label prospective randomized study carried out on 150 patients with mastalgia who were evaluated in our institute. Patients in Group A were given Tab Centchroman 30mg once daily after meals for 3 months and those in Group B were given Capsule EPO 1g once daily after meals for 3 months. two groups were assessed for pain score according to VAS, regression of pain at 3 months, recurrence of mastalgia after stopping the drugs decrease in nodularity at 3 months. Although both the drug groups showed a significant decrease in breast pain, Centchroman caused a steeper decrease of breast pain over 3 months. The effect of EPO, though significant at 3 months, was short lived on stopping the drug as the pain started resurfacing at 6 months. By way of the present study, we have shown the beneficial and lasting effects of Centchroman in the treatment of mastalgia and advocate its use as a primary drug in cases of mastalgia that do not respond to reassurance alone and require systemic therapy.