Background: Indian population experiences most common cancers of Lung, Breast, prostate most commonly where the disease is systemic to start with, and a high chance of metastasis to bones. Our institute experience most common radiotherapy emergency of cord compression so regularly that we need to frame a protocol for this cases on priority and the linac machine time is also so precious. Objectives: To compare the overall response in patients treated with two different fractionation schedules of 4 Gy x 5 fractions versus 3 Gy x 10 fractions for metastatic spinal cord compression. Materials and Methods: It is a prospective comparative study with total number of patients enrolled in the study is 60. After obtaining informed consent, then patients were enrolled in the study. Patients with known biopsy proven tumour presenting with metastatic spinal cord compression causing lower limb motor dysfunction. Results: Results of the study showed that overall response to radiation and ambulatory status of patients post irradiation were similar in both arms. There was no significant difference between the arms. Conclusion: Comparatively no difference in over all response and ambulatory status of patient by different fractionation. In general patients with MSCC have a poor survival and short course fractionation with 4 Gy x 5 fractions can be considered instead of the standard 3 Gy x 10 fractions.