Background: Labour pain can be intense and physically and psychologically taxing. Various pharmacologic interventions, including opioids like tramadol, are commonly used to alleviate labor pain. Tramadol, a synthetic opioid, is known for its reduced sedative and respiratory depressant, making it a potential alternative to traditional opioids. This study aimed to evaluate the efficacy of tramadol in alleviating labor pain, its impact on labor duration, and maternal and fetal outcomes. Methods: The study was conducted at Department of Obstetrics and Gynaecology, Government Medical College, Srinagar over two years from November 2018 to November 2020, involving 250 women aged 18-35 years, divided into two groups: the study group (n=125) patients who received intramuscular tramadol (100 mg), and the control group (n=125) patients who refused to receive labour analgesia. Pain relief was assessed using the Rupee scale, and maternal and neonatal outcomes were monitored, including APGAR scores at 1 and 5 minutes. Results: Results showed that tramadol significantly alleviated pain, with 50% of patients in the study group experiencing no pain during the first stage of labor compared to 36.8% in the control group. The study group also had a lower caesarean section rate (10.4%) compared to the control group (22.4%). Neonatal outcomes were better, with 96% of babies in the study group having an APGAR score of ≥7 at 1 and 5 minutes compared to 86% in the control group. Maternal morbidity was significantly lower in the study group (p = 0.009). Side effects from tramadol were mild and did not significantly affect outcomes. Conclusion: In conclusion, intramuscular tramadol is an effective, safe, and cost-effective analgesic for labor pain management. It reduces pain, shortens labor duration, and improves neonatal outcomes, with minimal maternal morbidity, making it a beneficial option for both mother and baby.