Background: In this study, we wanted to compare the efficacy of dexmedetomidine as an adjuvant to ropivacaine with that of ropivacaine alone, in ultrasound guided axillary brachial plexus block. Methods: This was a hospital based randomized controlled double blinded study conducted among 68 patients who presented for surgery involving the upper extremities while receiving an axillary brachial plexus block in the Department of Anaesthesiology of a tertiary care centre, after obtaining clearance from Institutional Ethics Committee, and written informed consent from the study participants. Results: Time of sensory onset and motor onset were statistically significantly higher in cluster R compared to cluster RD (P-value < 0.05). Time of sensory and motor duration, were statistically significantly higher in cluster RD compared to cluster R (P-value < 0.05). The median total rescue analgesia required in 24-hrs, was statistically significantly higher in cluster R when compared to cluster RD (P-value < 0.05). Conclusion: Adding Dexmedetomidine to Ropivacaine improves post-operative pain relief after ultrasound-guided axillary brachial plexus blocks for upper-extremity procedures.