Background: Spinal anesthesia has become the choice in obstetric patients awaiting cesarean section for its characteristics in providing rapid onset of anesthesia, allowing the mother to immediately interact with her baby. We were going to investigate the effect of the sitting and the lateral decubitus positions in the performance of spinal anesthesia for elective cesarean sections. The objective was to compare the onset time of anesthesia, the total requirement of ephedrine and hemodynamic changes in the Two Groups. Materials and Methods: After ethics committee approval, this comparative observational study was conducted in the Department of Anesthesiology at Sri Manakula Vinayagar Medical College and Hospital, Puducherry. A total of 72 parturients who met the inclusion criteria were enrolled into the study and were alternatively prepared for spinal anesthesia either in the sitting or in the left lateral position. The onset time taken for anesthesia to reach T4 level, the total requirement of ephedrine and hemodynamic parameters were recorded. Results: The Two Groups were comparable with regards to age, weight, gestational period and ASA grade. The mean and SD of onset time - Sensory Blockade in minute after Injection in sitting position group was 3.833 ± 2.049. Similarly it was 4.75 ± 2.089 for the lateral position group. The mean and SD of Ephedrine requirement in milligram in sitting position group is 8.5 ± 6.313. Similarly it was 7.5 ± 6.934 for the lateral position group. There were no significant difference between the groups. Conclusion: Our results showed no significant differences between the sitting and left lateral positions regarding the time taken to achieve T4 dermatomal level of anesthesia, the incidence of hypotension depicted by the total requirement of injection ephedrine and overall hemodynamic variables. We concluded that the sitting or the left lateral decubitus position in the performance of spinal anesthesia for cesarean section does not influence on the onset time of anesthesia and incidence of hypotension.