Evaluation is an important component of a teaching learning curriculum. Multiple choice questions (MCQs) are used as an objective and reliable tool to evaluate learning performance of students. The aims of this study were to evaluate MCQs for developing a pool of valid items and to update question bank for designing question paper in future. The marks obtained by 122 second year MBBS students in total 88 MCQs during three internal theory examinations in Pharmacology were analysed. Each correct response was awarded 1 mark while incorrect response was awarded 0. A list was generated with the marks of the student scoring in a descending fashion. The list was then divided into two equal group as high achievers and low achievers. MCQ analysis was conducted based on difficulty index (DIF I), discrimination index (DI), and distractor efficiency (DE). DE of items with different values of DIF I and DI was further analyzed by SPSS with 95% level of significance using unpaired t- test. Total 88 MCQs and 264 distractors were analyzed. Means and standard deviations (SD) for DIF I, DI and DE were 58.15 ± 2.19%, 0.69 ± 0.03, and 19.68 ± 3.26%, respectively. The difference in DE among changing DI was statistically significant with t=9.61, df=82, p<0.0001. Item analysis is a simple and feasible method of assessing valid MCQs in order to achieve the ultimate goal of medical education.