Aim: The aim of the present study to compare the safety and efficacy of Alcaftadine 0.25%, Olopatadine hydrochloride 0.2% and Bepotastine besilate 1.5% in allergic conjunctivitis. Methods: A total of 150 patients with mild or moderate allergic conjunctivitis were randomized into three groups with an allocation ratio of 1:1:1 using computer-generated random number sequence to receive topical anti-allergic medication for 14 days as Group 1: Topical 0.25% Alcaftadine eye drops OD, Group 2: Topical 0.2% Olopatadine eye drops OD and Group 3: Topical 1.5% Bepotastine besilate eye drops BID. Patients were examined and their baseline symptoms and signs (TOSS) were recorded. Results: A total of 180 patients were screened for the study of which 150 patients with mild or moderate allergic conjunctivitis, who met the required inclusion and exclusion criteria were included in the study. The 4 major complaints recorded by patients were itching (50 patients, 100℅), redness (37 patients, 74%), tearing (42 patients, 84%), and swelling (20 patients, 40%). The total ocular symptom score (TOSS) showed a consistent decrease in subsequent visit in all the Groups and it was statistically significant, when compared from baseline to 14th day in all the groups (p = 0.0006). The difference in mean TOSS between (Group A) Alcaftadine and (Group C) bepotastine treatment groups was observed at the third day of follow-up. This showed early relief of allergic conjunctivitis symptoms by bepotastine (5.77 ± 1.46) compared to Alcaftadine (mean (6.36 ± 1.58) and olopatadine (6.36 ± 1.58) but this was not statistically significant. Conjunctival hyperaemia had reduced in all the treatment groups but there was a significant reduction in Alcaftadine and Bepotastine treatment groups at 14th day compared to olopatadine group (p = 0.0025) Conclusion: All three topical ophthalmic medications used in the study are safe and effective in the treatment of allergic conjunctivitis. However, Bepotastine and Alcaftadine appear to outweigh Olopatadine in resolving the symptoms of allergic conjunctivitis.