The purpose of this study was to determine the effectiveness of intraarticular (ia) bupivacaine and tramadol injection and preemptive intraarticular tramadol in providing pain control after arthroscopic knee surgery. Following local research ethics committee approval, 60 patients were assigned in a randomized manner into three groups: Group I received ia 20 ml of 0.25 % bupivacaine at the end of the operation, Group II received ia 20 ml of 0.25 % bupivacaine and 100 mg of tramadol at the end of the operation and Group III received ia 100 mg of tramadol diluted in 20 ml of saline solution 30 minutes before skin inscision and 20 ml of 0.25% bupivacaine at the end of the operation as well. Analgesic duration, total analgesic consumption and postoperative VAS pain scores recorded at rest and with movement were significantly lower and patient satisfaction was significantly higher in Group II and III, compared to Group I. Total analgesic consumption and the number of patients requiring supplementary analgesics were significantly lower in the preemptive tramadol group compared to the postoperative tramadol group. In conclusion, preemptive ia tramadol provided effective and reliable pain control after artroscopic knee surgeries and may be preferred to postoperative administration.