Background: Adequate postoperative analgesia remains an essential component of perioperative care for lower abdominal surgeries. Intrathecal hyperbaric levobupivacaine has gained popularity due to its less cardiotoxic profile compared to bupivacaine. Adjuvants such as dexmedetomidine, an α2-adrenergic agonist, and fentanyl, an opioid, may enhance the quality and duration of spinal anesthesia while minimizing side effects. Methods: In this prospective, randomized, comparative study, 90 adult patients of American Society of Anesthesiologists (ASA) grade I/II, aged 18–60 years, were equally assigned into three groups. Group C received 15 mg hyperbaric levobupivacaine plus 0.5 mL 0.9% saline intrathecally, Group D received 15 mg hyperbaric levobupivacaine plus 4 µg dexmedetomidine (diluted to 0.5 mL), and Group F received 15 mg hyperbaric levobupivacaine plus 25 µg fentanyl (0.5 mL). Sensory block (onset, duration), motor block (onset, duration), hemodynamic parameters, and side effects were recorded. Postoperative pain was assessed using a Visual Analogue Scale (VAS), and the time to first rescue analgesic request was noted. Results: Demographic profiles were comparable across the three groups. The onset of sensory and motor block was significantly faster in Group D (6.32±0.62 and 9.77±0.55 minutes) compared to Groups C and F. Group D also demonstrated a significantly prolonged duration of sensory and motor block (94.27±3.96 and 96.43±4.90 minutes, respectively). The mean time to first request for analgesia was notably longer in Group D (281.80±7.21 minutes) than in Group C (135.33±3.61 minutes) and Group F (169.33±10.00 minutes) (p<0.001). Although hemodynamic changes were clinically insignificant among groups, Group D showed a higher incidence of bradycardia and hypotension, which were easily managed with appropriate interventions. Conclusion: Dexmedetomidine as an adjuvant to hyperbaric levobupivacaine provided rapid onset, prolonged sensory and motor block, and superior postoperative analgesia compared to fentanyl. Dexmedetomidine is a promising alternative for enhanced spinal anesthesia in lower abdominal surgeries.