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Topical antibiotics are used empirically to hasten the clinical cure and prevent transmission. Tobramycin and Moxifloxacin eye drops are frequently prescribed but head to head clinical comparison was not documented from eastern India. This study was aimed to compare the efficacy and safety of both antibiotics in suspected acute bacterial conjunctivitis. This study was conducted from February 2019 to May 2019. 150 patients with suspected bacterial conjunctivitis were randomized into two groups to receive either Tobramycin sulphate 0.3% W/V or Moxifloxacin 0.5% W/V eye drops 4 times daily in the effected eye for a period of seven days in an open label manner. All participants were allowed to simultaneously apply tear substitute (Carboxymethylcellulose sodium 0.5% W/V) in both eyes thrice daily. Efficacy was measured on day 3 and 7 in terms of clinical cure rate which was defined as absence of any eye sign of conjunctivitis. Safety of the drugs was assessed by the overall ocular adverse events reported by the patients. 61 patients from Tobramycin group and 66 from Moxifloxacin group completed the full study. High clinical cure rates were achieved with both agents although it was slightly higher with Moxifloxacin on day 3 (56.06% versus 47.54%; p=0.37) as well as on day 7 (93.94% versus 88.52%; p=0.52) of follow up. A single case of slight blurring of vision was reported with Tobramycin, while another patient complained of mild irritation on eyes from Moxifloxacin group. Overall ocular adverse effects were very mild and comparable. Both Tobramycin sulphate 0.3% W/V and Moxifloxacin 0.5% W/V eye drops are equally effective as empirical therapy when used in acute bacterial conjunctivitis for seven days four times daily with causing negligible side effects. [ABSTRACT FROM AUTHOR]