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Abstract Background: Myofascial pain syndrome is a type of chronic pain disorder that affects a portion of the population.Purpose: The aim of this study was to compare the effects of high-power pain threshold ultrasound versus conventional ultrasound on upper trapezius myofascial trigger points. Methods: Seventy participants aged from 18-30 with active trigger points were randomly divided into three Groups, Groups A, B and C. group A received high-power pain threshold ultrasound twice/week for two weeks. group B received conventional ultrasound twice/week for four weeks. group C received sham ultrasound twice/week for four weeks. Visual analogue scale (VAS) scores, surface electromyography, pressure algometry and the Arabic Neck disability index (NDI) were used to evaluate participants at two time points (pretreatment and post-treatment). Results: Statistical analysis shown that there were significant change within-group of VAS, PPT, RMS, ANDI pre-post treatment in the three groups as (p<0.05). Between {u2013}group analysis there was no significant change in pre value of all variables as (p<0.05) while post treatment there was a significant improvement in RMS and PPT of the left side in group A compared with group C as (p<0.01).Groups A and B had significantly greater improvement in VAS scores and neck NDI after treatment than group C (p<0.005). In addition, group A had significant improvement in VAS scores and NDI after treatment than group B (p<0.005). Conclusion: Both techniques are effective methods for treatment of subjects with active trigger points, but high-power pain threshold ultrasound is superior |