Aim: to compared the efficacy and cost-effectiveness of topical fusidic acid and topical mupirocin in treatment of impetigo. Material and methods: This was an open label, prospective study to evaluate efficacy and cost effectiveness of topical 2% fusidic acid cream with topical 2% mupirocin ointment in treatment of impetigo. The study was conducted in Anugrah Narayan Magadh Medical college and Hospital, Gaya, Bihar, India, for 1 year. 120 patients age 1-30 years, either sex and clinically diagnosed as impetigo (bullous and non-bullous) with number of lesions up to 10 (bullous and non-bullous) were included in this study. The diagnosis of impetigo was confirmed clinically. Scoring system of the lesions was done with reference to parameters like erythema, edema, vesiculation, pustulation and crusting. Scoring was applied to each parameter in the following manner. Results: 120 patients enrolled in study, 73 were males and 47 were females. 75 patients were of age < 10 years, 29 were of age 10 – 20 years and 16 were of 20 – 30 years of age. 90 cases had non bullous lesions and 30 had bullous lesions. The number of lesions before treatment were 4.59±1.22 and after one week of treatment was 0.31±0.79 with p-value < 0.05 which was statistically significant. The wound area (cm2 ) before treatment was 3.54±0.89 and after one week of treatment was 0.38±1.22 with p-value < 0.05 which was statistically significant. The SSI before treatment was 2.43±0.52 and after one week of treatment was 0.17±0.51 with pvalue < 0.05 which was statistically significant. While in group II (Mupirocin), the number of lesions before treatment were 4.22±1.22 and after one week of treatment was 0.18±0.82 with p-value < 0.05 which was statistically significant. The wound area (cm2 ) before treatment was 3.53±1.18 and after one week of treatment was 0.21±0.88 with p-value < 0.05 which was statistically significant. Conclusion: Mupirocin is marginally more effective than fusidic acid but this difference was not statistically significant. Cost effectiveness of fusidic acid is less than mupirocin