The treatment strategies used in the management of allergic conjunctivitis (AC) are antihistamines, mast cell stabilizers, and sometimes antihistamine–mast cell stabilizer combinations or dual action drugs. The current study aims to analyze the symptomatic relief of AC in patients treated with Alcaftadine 0.25% and Bepotastine Besilate 1.5% ophthalmic solutions. A retrospective cohort study was conducted at the ophthalmology department of a tertiary care hospital with a study population of 80 patients affected by AC. The recruited patients were categorized into two groups; Group A was treated with Alcaftadine 0.25% once daily for one week, and group B was treated with Bepotastine Besilate 1.5% twice daily for one week. The symptoms of the patients were assessed using the Severity Index scale at different durations (baseline-at visit, after 15 minutes, one day, and one week). The response scores collected were tabulated, and statistically analyzed to determine the efficacy of the test drugs. The study showed that both patients taking Alcaftadine and Bepotastine were equally efficacious in ameliorating the symptoms of AC. However, Alcaftadine provided statistically significant results in relieving the itching and redness symptoms compared to Bepotastine. Patients were also more compliant in group A, as the frequency of drug administration was only once per day. No treatment-related adverse effects were reported in the groups. It was found that both Alcaftadine and Bepotastine were equally efficacious in ameliorating the symptoms of AC. However, Alcaftadine provided better relief for itching and redness symptoms. © 2022 Elsevier B.V., All rights reserved.