Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. A total of fifty patients having diabetic neuropathic pain are recruited based on the inclusion and exclusion criteria. At first visit, patients are randomly assigned to one of the two treatment groups either Epalrestat or Pregabalin. Statistical analysis using student unpaired t-test. The scales used are Dallas pain questionnaire scale, Pain drawing scale, Lower extremity function scale; Biothesiometry score and plasma glucose post prandial. In the Dallas pain questionnaire scale, Pain drawing scale, Lower extremity function right and left toe scale in visit II and visit III are is P>0.05 significant value. In the Biothesiometry score right and left toe scale the ‘p’ value is <0.05, it has found that the reduction of diabetic neuropathy between two treatment groups during visit III is statistically differs. The plasma glucose post prandial the ‘p’ value is 0.0445 and it is <0.05, it has found that the reduction of PGPP between two treatment groups during visit II and III is statistically differs. The study concludes that there was rapid reduction of pain scores in pain rating scale; biothesiometry scores and reduction of PGPP levels are more in Pregabalin therapy when compared to Epalrestat therapy. The above information indicates that the efficacy observed for diabetic peripheral neuropathic pain relief, was more with Pregaballin therapy at a dose of 150 mg daily.