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Gabapentin is popular analgesic adjuvants for improving postoperative pain management. The aim of this study was to compare the preventive effects of pre-emptive oxycodone and gabapentin on acute pain after elective abdominal hysterectomy. One hundred patients undergoing abdominal hysterectomy were randomly assigned to oxycodone group received 10 mg of oxycodone and gabapentin group received 10 mg of gabapentin 1 hour before surgery. The anesthetic technique was standardized, and the postoperative assessments included the amount of meperidine consumption, PONV and VAS for postoperative pain at arrival to recovery, 6, 12 and 24 h after surgery. Bleeding loss assessed during surgery. Postoperative pain scores were significantly lower in the gabapentin group compared with the oxycodone group. (P=0.0001) The total meperidine used in the gabapentin group was significantly less than in the oxycodone group. Postoperative nausea and vomiting (PONV) and blood loss during surgery were significantly decreased in gabapentin group. Based on the results of this study, Pre-emptive use of gabapentin 1200 mg orally, significantly decreases postoperative pain and PONV, rescues analgesic requirements and also bleeding loss during surgery in patients who undergo abdominal hysterectomy. Significant side effects were not observed.