Background: Post-craniotomy pain has historically been under-addressed, largely due to the prevailing notion that such pain is typically mild to moderate in intensity. As a result, it has received limited and inconsistent attention in clinical research. This research evaluated and compared the pain-relieving effectiveness of bilateral scalp nerve block (BSNB) versus the traditional use of opioids in cases undergoing supratentorial craniotomy. Aim of the work: Direct: Improve post-operative pain outcome in supratentorial crainotomy and decrease the need for post-operative morphine use. Indirect: Decrease hospital stay time. Methods: A prospective clinical study was conducted with 50 cases patients scheduled for elective supratentorial craniotomy under general anesthesia (GA). The participants were randomly divided into two equal groups. The control group (Group A) received only GA, while the intervention group (Group B) received GA combined with BSNB Results: Operative time was significantly longer in Group B in contrast with Group A (P