Labor analgesia is used to decrease the pain of labor while allowing the parturient to actively participate in birthing experience. Recent evidence based data suggests that labor analgesia does not prolong the duration of labor, does not increase the rate of cesarean section and of operative vaginal delivery; the fetal outcome also showed higher 5 minute Apgar score and less need for naloxone therapy in babies of such patients. Non pharmacological methods for labor analgesia include TENS (Transcutaneous electrical nerve stimulation), acupuncture, hypnosis and aromatherapy. Recent evidence indicates that older drugs like pethidine and butorphanol are ineffective in providing meaningful pain relief and newer synthetic opioids such as remifentanil and alfentanil are better options. Advances have also been made in neuraxial blocks which include refinement of CSE technique, patient controlled epidural analgesia, development of multi-orifice epidural catheter and introduction of new amide local anesthetics and other non-opioid adjuncts such as neostigmine and clonidine for labor analgesia.