The prognosis of bone metastasis is poor, with median survival measured in months, not years. Treatment remains an important issue to alleviate the complications and sufferings of the patients. This study was aimed to evaluate the pain response between single versus multiple fraction radiotherapy in metastatic vertebral bone disease. In this prospective quasi experimental study, the sample consisted of 60 patients of Oncology Dept., KYAMCH. Purposive sampling method was used. The respondents were divided into 2 arms, Arm A consisted of 30 patients, receiving 800 cGy single fraction RT, and Arm B consisted 30 patients who received 3000 cGy multiple fractions RT. The data were collected using a semi-structured questionnaire, which was constructed in line with the reviewed literature along with RECIST (Response Evaluation in Solid Tumor) criteria, VAS (Visual Analogue Scale) after 4 weeks of RT completion and Radiation Therapy Oncology Group (RTOG) criteria.