Patent ductus arteriosus (PDA) is more common in preterm newborns. Risk factors are mechanical ventilation, lack of antenatal steroids, surfactant use and metabolic acidosis. It is a significant cause of morbidity and mortality in preterm infants. Medical treatment modalities included indomethacin and ibuprofen. Both are cyclo-oxygenase inhibitor and associated with renal, hematological, gastrointestinal side effects. Recently few studies has shown that paracetamol is effective in duct closure and also has better side effect profile. It has also low cost and both preparation (oral and IV) is available. Yet further compartive randomized clinical trials are needed for recommendation.