Background: Spinal anaesthesia is the most preferred technique for infraumbilical surgeries. Hyperbaric Ropivacaine has been shown to produce reliable and predictable anaesthesia for surgery. Fentanyl, a synthetic lipophilic opioid and Dexmedetomidine, a new highly selective α2-agonist, have been used as neuraxial adjuvants in spinal anaesthesia to prolong intraoperative and postoperative analgesia. The present prospective randomized study is undertaken to investigate and compare the clinical effects of 0.75% hyperbaric ropivacaine with additives such as fentanyl and dexmedetomidine on spinal anaesthesia for infraumbilical surgeries. Aim: To compare the clinical effects of intrathecal 2ml of 0.75% hyperbaric ropivacaine with fentanyl 25μg and dexmedetomidine 10μg as additives in patients undergoing elective infraumbilical surgeries. Materials & Methods: The study was conducted on 90 patients of both sexes, aged 18-60 years, of class I or II of the American Society of Anesthesiologists classification, who underwent elective infraumbilical surgery. Patients were randomly assigned to three groups (30 patients each): group RC (control group) received 2ml (15mg) of 0.75% hyperbaric ropivacaine plus 0.5ml of normal saline (0.9%) at a total volume of 2.5ml intrathecally, whereas group RF received 2ml (15mg) of 0.75% hyperbaric ropivacaine plus 0.5ml of 25μg fentanyl (50 μg/ml) at a total volume of 2.5ml intrathecally and group RD received 2ml (15mg) of 0.75% hyperbaric ropivacaine plus 0.5ml of 10μg dexmedetomidine (50μg dexmedetomidine diluted in 2.5ml of normal saline) at a total volume of 2.5ml intrathecally. The onset, extent, duration of sensory and motor blockade, time to first rescue analgesia request, hemodynamic parameters, and side effects such as nausea, vomiting, pruritis, respiratory depression and shivering were recorded. Results: The onset of sensory block was faster in Group RD (1.5±0.8) and Group RF (2.2±0.4) as compared with Group RC (2.7±0.4) min (p<0.0001). Time to achieve the maximum level of sensory block was faster in Group RF (4.13±0.77) compared to Group RD (5.16±0.94) and Group RC (5.63±0.49) min (P<0.00001). Two-segment regression time was longer in Group RD (120±15.7) and Group RF (114±14.5) as compared with Group RC(96±12.2) min (p<0.0001). The time of onset of motor block in Group RD (3.4±0.7), Group RF (3.8±0.9), and Group RC (3.7±0.5) min was statistically insignificant(p=0.08). The duration of the motor block in Group RD (308±19.1) and Group RF (233±18.7) was significantly longer as compared with Group RC (184±10.3) min (P<0.0001). The duration of postoperative analgesia was significantly longer in Group RD (365±23.5) and Group RF (275±20.6) as compared with Group RC (232±29.0) min (P<0.0001). Conclusion: The addition of dexmedetomidine to hyperbaric ropivacaine in spinal anaesthesia for infraumbilical surgery hastens the onset of sensory block, prolongs sensory and motor block recovery time and provides excellent quality of postoperative analgesia with minimal hemodynamic and other side effects compared with hyperbaric ropivacaine alone or fentanyl combined with hyperbaric ropivacaine.