Introduction: Anaesthesia is distributed similarly in the supraclavicular and infraclavicular brachial plexus blocks, and both are useful for procedures involving the upper limb. Aim: The aim of this study was to compare the ultrasound-guided supraclavicular and infraclavicular approaches of brachial plexus blocks. Materials and methods: Two groups were randomly assigned to 166 adult patients who were scheduled for elective upper limb surgery of the elbow and/or below: the supraclavicular Group (S) and the infraclavicular Group (I). Ultrasound guidance was utilized during the execution of each and every block. The block performance time, number of needle advancements, surgical preparedness, success rate, and complications were compared between the two groups. The Student t test and Chi square test were used for the statistical analysis. Results: The infraclavicular group's block performance time was (11.50 ± 1.76) minutes, while the supraclavicular group's was (4.96 ± 0.32). The infraclavicular group had 3.01± 0.74 needle advances, compared to 1.88± 0.39 for the supraclavicular group. The supraclavicular group showed two incidences of ulnar nerve sparing, whereas the infraclavicular group showed equivalent effectiveness in both procedures. In Group S, there were two incidences of phrenic nerve palsy and one patient had developed Horner syndrome. Conclusion: The effectiveness of supraclavicular and infraclavicular block is comparable. While the infraclavicular block was more difficult to perform and required more needle advancements which can be reduced with regular practice and experience but it avoided complications associated with the supraclavicular approach. The supraclavicular block was easier to perform but was associated with complications like Horner syndrome (2 cases), Phrenic nerve block (1 case), and Ulnar nerve escape (2 cases).