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Purpose: This study was conducted to compare between the effects of topical anesthesia and hand weight bearing on controlling upper limb spasticity in hemiplegic cerebral palsy children. Materials and Methods: Thirty hemiplegic cerebral palsy children from both sexes, ranging in age from 4 to 6 years with spasticity grade of 1 to 1+. The patients were assigned randomly into two groups (I and II). The range of motion of elbow and wrist extension and hand grip strength were determined before and after three months of treatment. Both groups received a designed exercise program, for one hour, 3 times / week for 3 successive months, in addition; group I received topical anesthesia on the affected upper limb for 30 minutes, while group II received a maintained weight bearing in diagonal extension position for 30 minutes. Results: Study results revealed significant improvement in all measuring variables of both groups when comparing their pre and post treatment mean values. Significant difference was observed in group II, when comparing the post treatment mean values of the range of motion of both groups. Conclusion: Topical anesthesia and hand weight bearing may be used for modulation of upper limb spasticity when combined with exercise program and increases the range of motion of elbow and wrist extension. [ABSTRACT FROM AUTHOR]