Background: Assessment is an important part of the learning cascade in education. Students realize it as an influential motivator to direct and guide their learning. The method of assessment determines the way the students reach high levels of learning. It has been documented that one of factor affecting students’ choice of learning approach is the way how assessment is being performed. Many methods of assessment namely multiple choice questions, essay questions and others are mainly used to assess basic science knowledge in undergraduate education. Objectives: The aim of this study is to compare multiple choice questions (MCQ) and essay questions (EQ) (record the success and failure rate of multiple choice questions (MCQ) and essay questions (EQ)) in regards to the Physiology questions. Methods: A retrospective study was done in which the results of the physiology exams -held in the medical college in Baghdad University -in 2010 are recorded. The number of students underwent the exam was 255. A total of 100 essay questions (EQs) and 100 multiple choice questions (MCQs) were evaluated from the written examinations delivered to second year medical students questions belonged to final examination. Results: Regarding essay questions that have been answered, 33.5% of the questions were not answered as a total. 188 students out of 255 had succeeded which represent 73.7% of the students. Out of 78 marks for MCQ, 46.33 had been achieved, and out of 22 marks for essay 12.9 have been achieved. the success in MCQ questions was 82.9% while in the Essay questions was 67.7% and the failure in both types was 12.5%. Out of 100 questions for both MCQ and Essay questions 55.1±7.9 questions were answered for the MCQ and 51.1±15.3 Essay questions were answered. In general the percentage of the succeeded students was 73. 7% and that of failed students was 26.3%. Conclusion: There is no significant difference in the success rate between MCQs and EQs.