Background: A popliteal blockade involves the injection of a local anesthetic near the popliteal nerve and its branches, which are located at the back of the knee. The present study was conducted to compared combined popliteal and saphenous nerve block vs NSAIDS for post operative analgesia in below knee surgery patients. Materials & Methods: 50 patients scheduled for knee and below knee surgeriesof both genderswere divided into 2 groups of 25 each. Group I patients received a combined popliteal and saphenous nerve block and group II received intravenous NSAIDS at the end of surgical procedure. Post operative VAS score, time for first rescue analgesia, total diclofenac requirement, total anti-emetic requirement and complication Results: The mean weight was 57.3 kgs and 58.2 kgs, height was 161.3cms and 162.5cms, duration of surgery was 62.5months and 56.4months and SA grade (I/II/III) was seen in 20/5 and 19/6 in group I and II respectively. The difference was non- significant (P>0.05). Analgesic requirement for the first time (mins.) was 652.1 and 290.5, VAS at time of first analgesicrequirement was 4.62 and 6.85, total consumption of diclofenac within 24 hours was 124.3 and 224.8 and post-operative score for nausea and vomiting was 1.2 and 1.9. The difference was significant (P< 0.05). Conclusion: Combined popliteal and saphenous nerve block provides significantly better postoperative pain relief than NSAIDS in patients who underwent below knee surgeries.