Abstract Paracetamol is the most widely used drug in the world, but its mechanism of action is unknown. As shown in new studies, it has a novel metabolism, via a metabolic pathway that involves generation of an active aminophenol metabolite through its metabolism in the liver by acylamides/N-D-acetylases, and paracetamol metabolism. to its hepatic metabolism CYP2A6. As the experiments were conducted using the molecular docking program, where the dopamine receptors were linked with the new metabolite, paracetamol, and the study showed compatibility during the binding, and this indicates that the mechanism of action of paracetamol is through the dopamine D2 receptors. Thus, the mechanism of action of its analgesic and antipyretic effect depends on the activation of dopamine D2 receptors through two mechanisms of action. This paper describes experimental data that demonstrated the involvement of these two metabolic pathways in the analgesic and antipyretic action of paracetamol and its relationship to dopamine D2 receptors. It also explains how new targets and systems play an important role in the action of paracetamol. Finally, pain and antipyretic treatment strategies.