Background Acne vulgaris is a common inflammatory skin disease affecting the pilosebaceous units of the skin in which propionibacterum acnes (P. acne) is one of the primary factors involved in its pathogenesis. Aim we aimed to evaluate the effectiveness of topical nicotinamide 4% gel versus topical 1% clindamycin gel for the treatment of mild to moderate acne vulgaris. Methods A total of 76 patients suffering from mild to moderate acne vulgaris were randomized to receive either 1% clindamycin gel or 4% nicotinamide gel, which were applied twice daily for a period of 8 weeks. The cases were diagnosed clinically and the degree of acne severity and side effects were assessed.