Background: Nasal bone fracture is the most common facial fracture (approximately 40 % of all the facial fractures) and is mostly treated with closed reduction. It is performed either with general or local anesthesia. Local anesthesia is fast and cheap but pain can’t be fully suppressed. We designed this study to see if pre-emptive analgesia with Acetaminophen can reduce the pain associated with nasal reduction under local anesthesia. Methodology/Principal: in this triple-blind randomized clinical trial we had 100 participants divided into two arms (either placebo or Acetaminophen 500 mg Tablet 45 minutes before reduction). Medication was randomly delivered via packages and the surgeon, patients, and data analyzer were all unaware of the nature of the medication. Then demographic data along with VAS pain scores (1-10 score from least to most severe pain) during local anesthesia, during reduction, and 24 hours after reduction were analyzed. Results: The patients were mostly men (74%) and the most common mechanism was involvement in fight. (30%). Left depression was the most seen type of fracture (53%). Pain scores as well as surgeon satisfaction analysis returned no statistical difference between the two groups. Correlation analysis was done and the only factor for pain severity during reduction was the number of tries needed. Conclusions: Acetaminophen pre-treatment can’t add analgesia any more than that of Placebo. Its use before reduction of nasal bone is not justified