Introduction This study aims to evaluatethe safety and the efficacy of Nalbuphine with fentanyl as an intrathecal adjuvant to hyperbaric bupivacaine. The objective to study the onset and duration of sensory blockage; time to two segment regression; hemodynamic changes. Material and Methods Two groups of thirty ASA Gr I and II patients of either gender were randomly assigned. Group I patients will get 0.8 mg (1 ml) of nalbuphine and 12.5 mg (2.5 ml) of 0.5 percent hyperbaric bupivacaine. Group II patients will receive 12.5 mg and 25 μg of Fentanyl (1 ml). Hemodynamics, sensory and motor block, early postoperative analgesia, and side effects were examined. The study included 18–55-year-old male and female patients. The study excluded patients with cardiac arrhythmias, heart blocks, or bradycardia; a known allergy to the test drug; a gross spinal abnormality, localised skin sepsis, haemorrhagic diathesis, neurological involvement/diseases; head injuries or raised intracranial pressure; and hemodynamic instability. Results Number of rescue analgesia in 24 hrs was significantly less needed among Hyperbaric bupivacaine with nalbuphine group. Systolic blood pressure fluctuation was high among hyperbaric bupivacaine with fentanyl than Hyperbaric bupivacaine with nalbuphine group. Diastolic blood pressure fluctuation was relatively greater among hyperbaric bupivacaine with fentanyl than nalbuphine group. SPO2 saturation fluctuation was almost similar in both the groups. The fluctuation between the groups was not statistically significant. Among hyperbaric bupivacaine with nalbuphine group 4 reported sedation and two reported nausea. Among hyperbaric bupivacaine with fentanyl group two had chest pain. Conclusion In this clinical study, nalbuphine added to hyperbaric bupivacaine at 0.5 percent was more efficient than fentanyl at enhancing postoperative analgesia and extending sensory motor blockade without increasing unpleasant effects.