Introduction: Since the introduction of spinal anaesthesia in 1898 by Dr. August Bier, who described the intrathecal administration of cocaine, spinal anaesthesia is preferred over general anaesthesia, particularly in surgical procedures of lower abdomen and lower limbs1 (D C Simon et al 2008). The aim of intrathecal local anaesthetic is to provide adequate sensory and motor block necessary for all below umbilical surgeries. Hyperbaric Bupivacaine is the most commonly used intrathecal local anaesthetic. Various adjuvants have been added to Bupivacaine to shorten the onset of block and prolong the duration of block. A number of adjuvants such as clonidine, Midazolam, opioids have been studied to prolong the effect of spinal anaesthesia3,4 (Elia N.et al 2008, Boussofara et al 2006). Clonidine has side effects like bradycardia, hypotension, dryness of mouth, nausea, respiratory depression, itching, and neurological toxicity. Dexmedetomidine is a new highly selective α2 agonist. It is α2 agonist drug, when given intrathecally, significantly prolongs the duration of spinal block. Intrathecal α2 receptor agonists have been found to have antinociceptive action for both somatic and visceral pain5 (Al Ghanem SM et al 2009). It is hypothesized that intrathecal 5 µg Dexmedetomidine would produce more postoperative analgesic effect with hyperbaric Bupivacaine in spinal anaesthesia with minimal side effects5-7 (Al Ghanem, Al Mustafa et al 2009 & Kanazi GE). To see whether the Dexmedetomidine alleviates the side effects of clonidine & Midazolam, we decided to study the efficacy and safety profile of Dexmedetomidine in combination with local anaesthetic in subarachnoid block for below umbilical surgeries.