Background: Sambucus nigra or also known as Black elderberry or European elderberry is been used for the teatment and prevention of various diseases. The plant posseses health beneficial effects such as antimicrobial, antioxidant, antiulcerogenic, antidepressant, antidiabetic, antiviral and antiinflammatory. However, there is limited report on the antitrichomoniasis activity of S. nigra. Objectives: The study aimed to comparatively analyze the in vitro trichomonicidal effects of various extracts prepared from both fruits and flowers of S. nigra. Half maximal inhibitory concentration (IC50) and minimum parasiticide (MPC) values of the extracts against metronidazole-resistant Trichomonas vaginalis 50143 strain were determined by the liquid microdilution method using 96-well microplates. Results: After 48 hrs incubation with parasites, the highest activities were observed for 70% hydroethanolic extract, chloroform extract and methanol extract of fruits with IC50 values of 513, 531 and 566 µg/ml, respectively. Fruit extracts exhibited higher activity than flower extracts, and no activity was observed in methanol extract of flowers. Conclusion: This study is the first comparative analysis of the anti-Trichomonas vaginalis activity of elderberry extracts. This study will serve as a reference source in isolating the components of elderberry fruits with antiparasitic activity. Peer Review History: Received 23 March 2024; Revised 6 May 2024; Accepted 27Metronidazole June; Available online 15 July 2024 Academic Editor: Dr. Amany Mohamed Alboghdadly, Ibn Sina National College for Medical Studies in Jeddah, Saudi Arabia, amanyalboghdadly@gmail.com Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Sangeetha Arullappan, Universiti Tunku Abdul Rahman, Malaysia, sangeetha@utar.edu.my Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com