Background: Scabies is an infectious skin disease caused by an ectoparasite called Sarcoptes scabiei var. hominis. The primary modes of transmission in classic scabies is direct, skin-to-skin contact, including sexual contact with an infected person, and rarely in cases of crusted scabies fomite-mediated transmission is seen. Scabies can be treated both with topical and oral medications. But still there are insufficient numbers of high-quality studies comparing the efficacy, safety and acceptability of different therapies for individual treatment. Objectives: To compare the efficacy of a single and double dose of oral Ivermectin versus two doses of topical permethrin for the treatment of scabies at church schools, a primary & tertiary hospitals in Bahir Dar, Ethiopia (July – September 2022) Methods: A health facility and institutional based, prospective, randomized, comparative clinical trial was conducted using an interviewer-administered, pre-developed data collection format. A total sample size of 92 clinically diagnosed cases of scabies were randomized to one of the three treatment groups single dose oral Ivermectin (200 µg/kg/dose) (Group I), double dose oral Ivermectin (200 µg/kg/dose) (Group II), and twice application of permethrin 5% cream repeated at 1 week interval (Group III) according to random allocation number generated using Microsoft excel. Study participants were re-evaluated after 4 weeks for improvement. Study participants data was entered into Microsoft excel before it was analyzed using SPSS version 26 software. Results: At the end of fourth week the clinical cure rate in double dose oral Ivermectin was 100%, while the Permethrin 5% cream and single dose Ivermectin showed 93.3% & 83.9% response respectively. The difference in efficacy between the three arms was statistically non-significant (P > 0.05). Conclusions: Both oral single and double dose regimen of Ivermectin and Permethrin 5% cream are equally efficacious and suitable as a treatment choice. KEY WORDS: Double dose Ivermectin, Single dose Ivermectin, Permethrin 5% cream, Treatment outcome, AAPH, TGSH