The name Segmental spinal anaesthesia is often widely used synonymously with Thoracic spinal anaesthesia. But in real sense segmental spinal anaesthesia means “blocking of the required dermatomes essential for the proposed surgical procedure with very low effective local anaesthetic drug dose “. This often necessitates dural puncture at high lumber or thoracic levels apart from the conventional spinal. Segmental spinal anaesthesia has been found to be feasible, safe, and effective alternative to conventional general anaesthesia in abdominal and some thoracic surgeries. The objective of this special article is to demonstrate the safety, benefits, risks and utility of this technique as a sole anaesthetic technique or combined with epidurals.