Background: Spinal anesthesia is a safe and effective technique in Cesarean sections, with the combined spinal-epidural procedure emerging as an alternative. Lowering the standard bupivacaine dose can reduce complications and improve maternal cardiac index. Adjuvants can enhance low-dose bupivacaine's effectiveness. However, hypotension remains a major issue, affecting 70-80% of patients. This study evaluates low-dose bupivacaine's efficacy in Cesarean sections, offering insights for optimizing anesthetic practices. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2009 and 2024. To ensure the inclusion of high-quality sources, editorial pieces and review articles were excluded unless they were accompanied by a DOI. The literature search was conducted using several reputable databases, including ScienceDirect, PubMed, and SagePub, to comprehensively gather relevant studies. Result: The study conducted a comprehensive review of over 1,000 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Following an initial screening, eight publications were identified as warranting more in-depth analysis. Consequently, a thorough review of these selected studies was performed to ensure a detailed and rigorous evaluation. Conclusion: The recovery of motor and sensory functions in Cesarean sections with lowdose bupivacaine showed significant improvement in cardiac index (CI) compared to conventional doses. However, hypotension incidence was comparable across both dosing strategies. Optimizing spinal anesthesia dosing and positioning is crucial for optimal maternal and fetal outcomes.