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Background and Aims Post-operative analgesia is an essential aspect for maternal recovery, ambulation, and well-being. Combining analgesics may enhance pain management, while reducing opioid use as well as postpartum depression risk. This study compares acetaminophen-diclofenac versus acetaminophen alone for post-caesarean analgesia.Methods A systematic search was conducted in December 2024 without date restrictions using PubMed, EMBASE, and Cochrane Central. We included studies that compared acetaminophen-diclofenac and acetaminophen alone after elective caesarean sections. The primary outcome was resting visual analogue pain scores (VAS) at various post-operative times. Risk ratios (RR) for binary and standard mean differences (SMD) for continuous outcomes were calculated using a random-effects model. I2 statistics were used to assess for heterogeneity.Results Five RCTs were included; 200 (47.8%) patients received acetaminophen-diclofenac, and 218 (52.2%) acetaminophen alone. Differences in resting VAS at 2-hours (SMD -0.82; 95%CI -1.52, -0.11; P=0.02), 6-hours (SMD -0.95; 95%CI -1.72, -0.18; P=0.02), 24-hours (SMD -0.61; 95%CI -1.08, -0.15; P=0.01), and morphine consumption (SMD -0.83; 95%CI -1.48, -0.17; P=0.01) were statistically significant. No significant difference was found for the side-effect of nausea/vomiting (RR 0.63; 95%CI 0.28, 1.40; P=0.25).Conclusions In this meta-analysis, a significant benefit in acetaminophen-diclofenac versus acetaminophen alone was found for four of five outcomes, suggesting a possible advantage in maternal analgesic management from this combination. However, given a relatively small population, more RCTs may be needed to confirm this observation.Abstract OP05 Figure 1(A) Mean VAS pain score at 6 hours between groups; (B) Mean cumulative morphine consumption (mg) over 24 hours between groups