Typhoid is the most prevalent bacterial cause of fever among migrants and visitors who have just left these regions. According to estimates from the Global Burden of Disease Study in 2017, 136 000 fatalities occur yearly, mostly in low- and middle-income countries, and there are around 14 million afflicted individuals. Objective: To compare the time of defervescence with Ceftriaxone and Ceftriaxone-Azithromycin combination in all cases of culture proven Enteric fever (typhoid/paratyphoid) and to assess the improvement of general wellbeing and hepatosplenomegaly. Material and Methods: This was a randomized controlled clinical trial conducted among 38 children between the ages of 1year to 18 years with culture positive enteric fever treated at the hospital. All the cases with blood culture positive for enteric fever i.e., S. Typhi and S. Paratyphi A and B grown on culture were divided into two groups. The first group was given IV Ceftriaxone at a dose of 100 mg/kilogram of bodyweight/day along with antipyretics. The second group was given IV Ceftriaxone at a dose of 100mg/kilogram bodyweight/day and Oral Azithromycin at a dose of 10mg/kilogram bodyweight/day as once a day dosing. Results: In the study mean day of fever Defervescence was 5.63 ± 1.89 days in group 1 and 3.89 ± 1.15 days in group 2. This difference in mean Day of Defervescence of fever between two groups was statistically significant. i.e., in Group 2 fever was reduced within 4 days. (p=0.002). All the subjects in both the groups had improvement. In our study, no case of relapse was found in both the groups when followed up over four weeks. In Ceftriaxone group among 17 subjects with Hepatomegaly and 13 subjects with splenomegaly all the subjects showed reduction in size at discharge and similarly in ceftriaxone + Azithromycin all the 18 subjects with hepatomegaly and 5 subjects with splenomegaly showed reduction in size at discharge. Conclusion: It is hypothesized that combination treatment might prevent the emergence of multidrug resistance in S. Typhi.