Background: Arterial hypotension is a potential hazard associated with spinal anesthesia. Routinely, crystalloids and colloids are used for managing hypotension. While crystalloids easily move out of the intravascular space, colloids are confined to the intravascular space, thereby minimizing the risk of hypotension. This study was carried out to compare the efficacy of 10% Hydroxyethyl starch with Ringer’s lactate solution. Methods: This double blind randomized controlled trial was carried out on 100 patients who underwent spinal anesthesia during the study period. The study participants were randomized into experimental group (6% Hydroxyethyl starch, 10 ml/Kg) and control group (Ringer’s lactate, 20 ml/Kg). Blood pressure and heart rate were recorded periodically up to 60 minutes. Sensory level of blockade was checked after 5 minutes. Results: It was observed that as the surgery prolonged, the incidence of hypotension increased among the controls compared to the experimental group. While the initial incidence was higher among the experimental group (24%), the incidence was greater for the controls beyond 25 minutes (42%). The difference in the incidence was statistically significant (p<0.05). Conclusion: Hydroxyethyl starch is superior to Ringer’s lactate solution in prevention of Hypotension following spinal anesthesia. Incidence of hypotension is reduced but not completely eliminated. Hydroxyethyl starch also has several other advantages such as prophylaxis against venous thrombosis and decreased allergic potential.