Background: Inappropriate prescribing has been recognized in several health facilities in developing countries that need to be assessed periodically to improve the therapeutic efficacy, reduce side effects and provide feedback to prescribers. The purpose of this study was to compare the prescribing pattern of NSAIDs in two hospitals of the orthopedic outpatient department located in the Kathmandu valley of Nepal. Method: A cross-sectional hospital-based descriptive study of a month duration (August 2017) with a purposive sampling method was undertaken for the data collection. WHO drug use indicators were selected to evaluate prescription patterns. A total number of 205 patients were eligible from hospital M and hospital K (135 and 70), respectively. Results: Among 135 patients studied in HM, the diagnosed orthopedic cases were joint pain (28.1%), low back pain (16.3%), traumatic case (19.3%), spinal case (3.7%) and others (32.6%) whereas studied 70 patients in HK were diagnosed joint pain (24.3%), low back pain (18.6%), traumatic case (14.3%), spinal case (8.6%) and others (34.3%). The frequency of prescription of Aceclofenac (73.3% and 54.3%) was highest among NSAIDs in HM and HK, respectively. The duration of NSAIDs prescribed was in percentage (50.4%) for ten days in HM, whereas it was 41.4% for seven days in HK. Conclusion: NSAIDs were the frequently prescribed drugs in the orthopedic OPD of both Hospitals. Joint pain was the most frequently encountered diagnosis. Aceclofenac was mostly prescribed conventicle non- selective NSAIDs. Along with NSAIDs, PPIs were also prescribed frequently. Based on the recommendation, NSAIDs were used for a short duration.