Objective: To compare the anesthetic efficacy and postoperative analgesia between 0.5% bupivacaine and 2mg dexamethasone and 0.5% bupivacaine alone in peribular block for small incision cataract surgery. Methods: 50 patients were randomized into 2 groups of 25 each to receive peribulbar anesthesia using 0.5% bupivacaine and 2mg dexamethasone in group I and 0.5% bupivacaine alone in group II. The patients were assessed for onset and duration of akinesia and postoperative analgesia. Results: Akinesia was achieved faster (6.32±1.11 mins) in group II when compared to group I (14.12±2.99 mins) which was statistically significant. The duration of akinesia was longer in group I (2.52±0.51 hrs) when compared to group II (1.36±0.40 hrs) which was also significant. The VAS scores were significantly lower at 0, 1, and 2 hrs in group I than in group II. Conclusion: The addition of dexamethasone to bupivacaine in the peribulbar block provided a prolonged duration of akinesia and analgesia with lower VAS scores postoperatively.