Background: Oral ivermectin is recently introduced for the treatment of scabies. Objective: The objective of this clinical trial was to compare the efficacy and safety of oral ivermectin and topical Gamma Benzene Hexachloride (GBH) 1% for the treatment of scabies. Patients and Methods: Fifty-eight cases were randomly assigned in the two treatment groups. In the ivermectin group, patients received a single oral dose of the drug (200 µg/kg). In the case of any signs of active disease, a second dose was administered one week later. All the patients in the GBH group received two topical applications of the drug, one week apart. The patients were seen after 48 hours, 1, 2, and 4 weeks. Results: Of the 37 patients treated with ivermectin, 27 (73%) showed clinical cure with a single dose and 10 (27%) required a second dose one week later. In the 21 patients treated with GBH, 18 (85.7%) received two applications of GBH, and three cases (14.3%) were cured by an additional curse of precipitated sulfur 6%. No serious side effects were seen in either group. The mean time for the drop of pruritus, the sense of well being and the healing of lesions, were each shorter with ivermectin than GBH, and the differences were statistically significant. Conclusion: Although all of the patients treated with ivermectin or topical GBH were cured, ivermectin cured faster than topical treatment.