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Background: Ropivacaine, a long-acting amide local anesthetic agent, is a pure S enantiomer of bupivacaine. Intrathecal adjuvants have been used with local anesthetics for better hemodynamics and to provide postoperative analgesia. In this study we used Dexmedetomidine in comparison with Fentanyl, as an intrathecal adjuvant. The aim of this study is to evaluate the onset and duration of sensory and motor block, hemodynamic effect, and adverse effects of Dexmedetomidine or Fentanyl given intrathecally with hyperbaric 0.75% Ropivacaine. Materials and Methods: In this randomized clinical trial, sixty patients belonging to American Society of Anesthesiologists class I and II scheduled for elective lower limb orthopaedic surgeries were studied. Patients were randomly allocated into two groups. Group RD received 3ml Hyperbaric Ropivacaine 0.75 % plus Dexmedetomidine 15 microgram and Group RF received 3ml of Hyperbaric Ropivacaine 0.75 % plus Fentanyl 25 microgram. Results: The time of onset of sensory block with Dexmedetomidine group (RD) (1.563±0.3min) when compared to Fentanyl group (RF) (2.475±0.4 min), was significantly shorter (P<0.05). The time of onset of motor blockade was also significantly faster (P<0.05) with Group RD (1.86±0.35min) than that of Group RF (3.75±0.67min). Patients in Dexmedetomidine group (RD) had a significantly longer sensory and motor block time than patients in Fentanyl group (RF). Conclusion:Dexmedetomidine as an intrathecal additive is associated with faster onset and prolonged duration of sensory and motor blockade, hemodynamic stability, and reduced demand for rescue analgesics in 24 hour postoperative period as compared to Fentanyl. [ABSTRACT FROM AUTHOR]