Bacterial vaginosis (BV) is the common disease of adult women that effects vagina leading to abnormal vaginal discharge due to the overgrowth of pathogenic bacteria. The most common drugs used to eradicate BV is oral metronidazole, secnidazole, tinidazole as well as vaginal metronidazole gel or clindamycin cream. This study aims to compare the efficacy of oral and vaginal metronidazole for the eradication of BV. A total 594 clinically diagnosed BV patients were enrolled in the study which were randomly divided into two groups. Group 1 received 5gms metronidazole vaginal gel daily for 5 days while group 2 were on oral metronidazole 400mg twice daily for 5 days. All the patients were followed for 14 days. The patients were considered cured if the microscopic examination didn’t reveal any clue cells. The mean age of patients in group 1 and group 2 was 32.7±2.1years and 33.4±1.5 years, respectively. Majority of patients in both groups were in between the age group of 36-45 years. The results showed that the therapeutic cure rate was high in group 1 as compared to group 2 (92.59% vs 85.85%) with p-value 0.01. Furthermore, the chances of recurrence of BV was high in group 2 (OR with 95% CI = 2.05, 1.19-3.5) suggesting that metronidazole vaginal gel is more effective in the treatment of BV as compared to oral metronidazole. The adverse events related to vaginal metronidazole is less because of its local effect and is associated with good result and relief of symptoms related to BV.