Introduction: Extreme pain in hip fractures does not allow ideal positioning for spinal anesthesia. Adequate pain relief before spinal anesthesia will enhance patient’s cooperation. We evaluated the analgesic efficacy of ultrasound guided PENG block and FIB for positioning and post operative pain relief in hip surgeries. Methods: This was a prospective, randomized, double blind study that included 60 patients aged 18-80 years of either sex belonging to ASA I to III undergoing hip surgeries. Group P [n=30] [USG guided Peng Block] - 25ml of 0.25% Ropivacaine Group F [n=30] [USG guided Fascia Iliaca Block} - 25ml of 0.25% Ropivacaine. Pain scores after the block, during positioning and post-operative period, opioid consumption and side effects if any were recorded. Statistical analysis done using student t test, chi-square test. Pvalue of < 0.05 was considered significant. Results: In Group P, mean VAS before block was 7.8 ± 0.47 which reduced to 0.6 ± 0.4 during positioning which is statistically significant (P<0.001), whereas in Group F, mean VAS before block was 7.6
± 0.4 which reduced to 2.6 ±- 1.2 during positioning. Duration of postoperative analgesia was comparable between the two groups. (490.4 ± 40.8 minutes in group P and 470 ± 40.48 minutes in group F) Conclusion: In Hip fractures, PENG block produces more effective analgesia for positioning and postoperative pain than Fascia iliaca block without any significant side effects.