Item analysis of Multiple Choice Questions (MCQs) is the process of collecting, summarizing and utilizing information from students' responses to evaluate the quality of test items. Difficulty Index (p-value), Discrimination Index (DI) and Distractor Efficiency (DE) are the parameters which help to evaluate the quality of MCQs used in an examination. This study has been postulated to investigate the relationship of items having good p-value and DI with their DE and their utility to frame 'ideal questions'. This study further evaluates the MCQs as a tool of assessment so as to improve the curricula in Medical Education. In this study, 20 test items of ‘Type A’ MCQ tests of assessment were selected. The p-values, DI and DE were estimated. The relationship between the p-value and DI for each test item was determined by Pearson correlation analysis. Mean p-value and DI of the test were 66.53 ± 16.82% and 0.41 ± 0.16% respectively. Only 20% of total test items crossed the p-value of 80% indicative of their easy difficulty level. 95% of the test items showed acceptable (> 0.2) DI. 12 out of 20 test items showed excellent DI (≥ 0.4). 8 (40%) test items were regarded as ‘ideal’ having p-value from 30- 70, and DI > 0.24. Correlation studies revealed that, DI associated with p-value (r = -0.288; P = 0.219). Mean DE of the test was 76.25 ± 22.18%. The DE was directly related to the DI. Items with good and excellent DI had DE of 66.67 ± 14.43% and 83.33 ± 19.46% respectively. In conclusion, an acceptable level of test difficulty and discrimination was maintained in the type A MCQ test. The test items with excellent discrimination tend to be in the moderately difficult range. There was a consistent spread of difficulty in type A MCQ items used for the test. Much more of these kinds of analysis should be carried out after each examination to identify the areas of potential weakness in the type A MCQ tests to improve the standard of assessment.