Objective: To compare the efficacy and safety of Olopatadine hydrochloride 0.2%, Alfetamine 0.25%, and Bepotastine baseplate 1.5% ophthalmic solutions in the treatment of vernal keratoconjunctivitis. Methods: This is a prospective, observer-masked, comparative study of 64 patients with mild to moderate vernal conjunctivitis, randomized into three groups of 23, 19 and 22, patients each. Each group was assigned to be treated with one of the three treatment options namely Alfetamine 0.25%, Olopatadine hydrochloride 0.2% and Bepotastine besilate 1.5% ophthalmic solutions. Patients were followed-up at regular intervals with relief and resolution of symptoms and signs noted using Total Ocular Scoring System (TOSS) and hyperemia scale. Results: All three topical medications were effective in resolving symptoms of the patients with mild to moderate vernal conjunctivitis. Baseline mean TOSS scores for Alfetamine group, Olopatadine group and Bepotastine baseplate group were (7.68±2.32), (7.65±2.32) and (7.45±2.27) respectively as compared to the corresponding TOSS scores on 14th Day (4th visit) which were (0.2 ± 0.43), (0.4 ± 0.56) and (0.1 ± 0.36) respectively. The resolution of symptoms in the Bepotastine and Alfetamine groups was significantly profound as compared to the Olopatadine group (p = 0.008). Bepotastine and Alfetamine groups significantly reduced allergic conjunctivitis symptoms compared to Olopatadine group (p = 0.008). Conclusion: All three topical ophthalmic medications used in the study are safe and effective in the treatment of vernal conjunctivitis. However, Bepotastine and Alfetamine appear to outweigh Olopatadine in resolving the symptoms of vernal conjunctivitis.