Objective <p>Enterobius vermicularis also known as pinworm is one of the most common parasitic infestations in humans. Repeated cycles of reinfection make it difficult to eradicate. Therefore, this study was planned to determine the efficacy of drugs in achieving remission and preventing recurrences of pinworm infestation.</p> Methods <p>This was an open-label randomized controlled trial conducted from March to August 2025 at Karaikal, Puducherry. Children aged 2–12&#xa0;years (<i>n</i> = 126) with confirmed pinworm infestation were randomized to one of the three groups (1:1:1)- albendazole (400&#xa0;mg stat dose), mebendazole (100&#xa0;mg stat dose) or pyrantel pamoate (11&#xa0;mg/kg stat dose) with a repeat dose of same drug after two weeks. The efficacy of the three drugs was compared by using a novel objective symptomatic remission (clearance of worms after treatment initiation) and recurrence (no reappearance of worms after remission) scores. Each parent was explained the hygiene measures to be followed and compliance to hygiene was checked in a diary during subsequent visits.</p> Results <p>Albendazole, Mebendazole and Pyrantel pamoate achieved the highest remission score in 70.5%,59.5% and 67.5% respectively; (<i>P</i> value = 0.483). The highest recurrence score was achieved by Mebendazole in 97.6%, followed by pyrantel pamoate (82.1%) and albendazole (69%); (<i>P</i> value = 0.010). The majority of the children (<i>n</i> = 113) practiced proper hygiene, among whom,102 (90.3%) had no recurrence of worms; <i>P</i> value = 0.001.</p> Conclusion <p>Albendazole, mebendazole and pyrantel pamoate had similar efficacy in inducing remission, while mebendazole was better than the other two agents in preventing recurrences.</p>