Background: For regional nerve blocks, a combination of dexmedetomidine with local anesthetic like levobupivacaine has shown improved effectiveness by extending the duration of analgesia and reduction in postoperative analgesic requirement. This study was undertaken to evaluate the effectiveness and efficacy of levobupivacaine alone and levobupivacaine with dexmedetomidine in axillary brachial plexus block. Materials and Methods: We included 70 patients of ASA category I, II, and III, posted for elective hand and forearm surgeries and randomly assigned them into two groups to receive either 24 ml 0.5% Inj.levobupivacaine and 1 ml normal saline (Group L) or 24 ml of 0.5% Inj.levobupivacaine and 1 mcg/kg of Inj.dexmedetomidine diluted to 1 ml with normal saline (Group LD). Results: In Group LD the onset of sensory block (16.13 ± 4.001 min) and motor block (18 ± 3.889 min) was significantly shorter compared to that of Group L. Duration of sensory block in Group LD was 677.25 ± 99.54 min and in Group L was 494.38 ± 70.64 min and the difference was clinically significant (p < 0.001). Duration of motor block in Group LD was 710.88 ± 87.32 min and in Group L was 526.25 ± 70.229 min and was clinically significant. Duration of analgesia in Group L was 576.88 ± 76.306 min and that in Group LD was 764.38 ± 110.275 min. There was a significant change in hemodynamics in Group LD as compared to that in Group L. Conclusion: Levobupivacaine along with sdexmedetomidine provides faster onset of anesthesia with extended duration of analgesia. It offers efficacious and trouble-free method of anesthesia and better analgesia in postoperative period for hand and forearm surgeries.