Background: To compare the efficacy of ketamine-lidocaine and fentanyl-lidocaine in postoperative analgesia in axillary block in upper limb fractures. Materials &Methods: A total of 40 patients within the age range of 20 to 65 years of ASA group I & II were enrolled. Complete demographic and clinical details of all the patients was obtained. Only those patients were enrolled who were scheduled to undergo upper extremity fractures under the axillary block. Initial monitoring of all the patients was done after entering the operating room. All the subjects were randomly divided into two study groups with 20 patients in each group as follows: Group A: Patients who received 4 mg/kg lidocaine 1% and 50 µg fentanyl, and Group B: Patients who received 4 mg/kg lidocaine 1% and 30 mg ketamine during the axillary block. Once the surgery was complete, patients were transferred to the recovery room, where evaluation of sensory and motor block was done. Postoperative pain was evaluated by visual analogue scale (VAS). All the results were recorded in Microsoft excel sheet followed by statistical analysis. Results: Among the patients of group A, mean postoperative VAS pain score was significantly higher at sixteen hours and twenty-four hours postoperatively in comparison to the patients of group B. Total rescue analgesia requirement was significantly higher among patients of group A in comparison to patients of group B. Conclusion: For the axillary block, both drugs were beneficial. But compared to ketamine, fentanyl might be a better medication to employ as an adjuvant in the axillary block because of the lower pain intensity and reduced demand for analgesics in the fentanyl group.