Introduction: When bleeding into gastrointestinal tract is profuse then the passage of blood through the rectum is easily detectable clinically. When the bleeding is chronic with only small amount of blood being passed in the faeces, the blood or its breakdown products are not recognized in the faeces that can only be detected by microscopy or faecal occult blood test. Aim and Objectives: To detect blood or blood product, faecal occult blood test is required along with stool microscopic examination as presence of blood in stool is suggestive of upper and lower gastrointestinal bleeding and has a great impact on patient care. Materials and Methods: In vitro testing of faecal occult blood was performed by Non-benzidine test kit for occult blood and microscopic examination by saline and iodine wet mount of stool sample. Results: Out of 454 random stool samples examined, 100 (22%) were positive for faecal occult blood test. Out of 100 positive faecal occult blood test cases 21% cases show red blood cells in stool microscopic examination, 70% cases showed anaemia with <10 gm/dl haemoglobin and only 23 had visible blood showing reddish or black colour. While out of 454 cases 11 (2.4%) showed red blood cells in stool microscopic examination but negative for faecal occult blood test. So microscopy shows only 21% sensitivity and 96% specificity as compared to faecal occult blood test. Efficacy of faecal occult blood test and microscopy is 90% and 29% respectively. Conclusion: The presence of detectable blood in stool is associated with increased risk of serious complication from a wide range of causes. For early diagnosis, faecal occult blood test should be done along with stool microscopic examination and undergone for complete diagnostic evaluation.