Background: In comparison to other approaches, spinal anaesthesia is often preferred for performing cesarean sections, but sharp needle discomfort can lead to substantial pain and psychological distress. To alleviate the suffering lidocaine infiltration, EMLA cream, and vapocoolant spray are often used. This meta-analysis aims to determine how EMLA cream compares with other opioid analgesic pre-treatment therapies with regards to pain inflicted during a spinal needle block in cesarean section women. Methods: A systematic review and meta-analysis of RCTs was conducted whereby a PubMed search was performed. Only studies which compared EMLA cream with vapocoolant spray or lidocaine infiltration for pain control during cesarean delivery were included. The main focus was the level of pain experienced, which was assessed using VAS or NPRS. Other patient-centered outcomes such as satisfaction, procedure time, and adverse event rate were analyzed as secondary outcomes. Data were analyzed with a random effects model, and effect measures were calculated as mean differences (MD) or odds ratios (OR). Results: After applying the inclusion criteria, four RCTs of 337 patients were found. The use of EMLA cream resulted in lower VAS pain scores in comparison to lidocaine infiltration (MD -1.42, 95% CI -2.03 to -0.81, p<0.001), but no difference was found compared to vapocoolant spray (MD 0.10, 95% CI -0.35 to 0.55, p=0.66). There was greater satisfaction with EMLA cream compared to lidocaine (OR 4.12, 95% CI 2.15 to 7.89, p<0.001). No difference was statistically significant for this study with respect to procedure time or adverse events. Conclusion: Though comparable to vapocoolant spray, EMLA cream exceeds lidocaine infiltration in pain management and patient satisfaction during spinal anaesthesia for cesarean delivery. With regard to the preoperative context, EMLA’s slower onset time can limit its effectiveness during emergencies, but proper preoperative placement can maximize surgical outcomes.