Cataract surgery is a common procedure with increasing demand, particularly in elderly patients with multiple comorbidities. We widely use peribulbar anaesthesia for this surgery, traditionally employing bupivacaine and lignocaine. Ropivacaine, due to its favourable pharmacological profile, is gaining popularity. When combined with local anaesthetics, clonidine, an alpha-2 agonist, can prolong the duration of analgesia and reduce the required dose of local anaesthetic. Objective: This study aimed to compare the effects of ropivacaine with lidocaine versus ropivacaine with lidocaine and clonidine in peribulbar anaesthesia for cataract surgery, focusing on cardiovascular parameters, intraocular pressure (IOP), duration of pain relief and the potential for reducing ropivacaine dosage. Methods: Fifty patients were randomly assigned to two groups: Group A (ropivacaine + lidocaine) and Group B (ropivacaine + lidocaine + clonidine). Various parameters including onset of sensory and motor block, duration of anaesthesia, hemodynamic stability, IOP and adverse events were assessed. Results: Group B demonstrated significantly faster onset times for sensory and motor blocks compared to Group A. The duration of anaesthesia did not differ significantly between groups. Both groups maintained stable hemodynamic throughout the procedure. Intraocular pressure was consistently lower in Group B. Adverse events such as bradycardia and hypotension were less frequent in Group B. Conclusion: For cataract surgery, the addition of clonidine to ropivacaine and lidocaine in peribulbar anaesthesia resulted in faster onset times of sensory and motor blocks, better control of intraocular pressure and fewer cardiovascular adverse events. These findings support the use of clonidine as an adjunct to local anaesthetics to improve perioperative outcomes and patient safety during ophthalmic procedures. We recommend further research with larger sample sizes and longer follow-up to validate these findings and explore additional benefits for postoperative recovery and patient satisfaction