Background: In contemporary anesthesia practice, the combined spinal epidural (CSE) is widely used. It offers postoperative analgesia, a quick onset, a longer duration, and a lower risk of local anesthetic toxicity. The present study compared sequential combined spinal epidural anesthesia with epidural volume extension in lower limb orthopaedic surgery. Materials & Methods: 90 patients scheduled for lower limb orthopaedic surgery of both genderswere divided into 2 groups of 45 each. Group I was sequential combined spinal epidural (SCSE) group and group II was epidural volume extension (EVE) group. All underwent lower limb orthopaedic surgery. In both groups, metrics were recorded, including anesthesia readiness time, modified Bromage motor score, motor block duration, sensory regression time to T12, general anesthesia supplementation, time to first request for postoperative analgesia, number of patients requiring pethidine, and mean pethidine consumption. Results: Group I had 25 males and 20 females and group II had 22 males and 23 females. Duration of surgery was 131.2 minutes in group I and 124.4 minutes in group II. Anesthesia readiness time was 23.1 minutes in group I and 21.5 minutes in group II. Duration of motor block was 184.2 minutes in group I and 154.2 minutes in group II. The mean modified bromage motor score was 2 in group I and 1 in group II. The difference was significant (P< 0.05). The mean pethidine consumption (mg) was 4.2 mg in group I and 3.1 in group II. Time for sensory regression to T12 was 131.2 minutes in group I and 120.2 minutes in group II. Supplementation with general anesthesia was 1.6 in group I and 3.2 minutes in group II, time to first request for postoperative analgesia was 226.6 minutes in group I and 190.1 minutes in group II. Number of patients who required pethidine was 6 in group I and 4 in group II. The difference was significant (P< 0.05). Conclusion: Both the sequential combined spinal epidural anesthesia and epidural volume extension procedures work well for individuals having orthopedic surgery on their lower limbs.