Objective: General or spinal anesthesia, caudal block, local anesthesia or combination of these techniques may be used for anorectal surgery. The best anesthetic technique and medications are still debated. This study was performed to compare the feasibility of the two spinal anesthetic techniques, namely, saddle block and low spinal anesthesia using plain levobupivacaine in elective perianal surgery. Material and Methods: Fourty ASA (American Society of Anesthesiologists) I-III patients were randomized to receive either saddle block (Group 1) or low spinal anesthesia (Group 2) with 1.5 mL plain levobupivacaine. In both groups, the degree of motor and sensory block, peri- and postoperative side effects, patient and surgeon satisfaction, analgesic requirements as well as durations of anesthesia, surgery and postanesthesia care unit were recorded. Results: The median level of sensorial block was significantly higher in Group 2 (p= 0.007). The sensorial block remained at sacral dermatomes in 35 % of patients in Group 1 and in none of the patients in Group 2 (p= 0.008). Bromage scores were "0" in 70% and 21.1 % of patients in Group 1 and Group 2, respectively (chi(2): 9.39, p= 0.002). Seventeen patients in Group 1 and seven patients in Group 2 achieved fast tracking criteria in the operating room and were able to bypass the postanesthesia care unit (chi(2): 11.493, p= 0.001). Conclusion: Saddle block with plain levobupivacaine used for perianal surgery resulted in absence or less motor block, less admission to postanesthesia care unit, faster recovery when compared to low spinal anesthesia; however side effects, patient and surgeon satisfaction were comparable between the groups.