Background Caudal block is a common regional technique used to provide intra andrnpostoperative analgesia of infra-umbilical procedures in pediatric patients. However, thernrelatively short duration of single shot caudal injection with local anesthetic is amongst thernlimitations of the procedure. Addition of various adjuvants has been challenged by unacceptablernadverse effects & safety not being fully established, especially in preservative containing agents. rnObjective The aim of this study was to compare effectiveness of caudal block with bupivacainernalone versus caudal block with bupivacaine and IV dexamethasone for postoperative analgesia ofrnpediatrics patient undergoing infra-umbilical surgery under General anesthesia at Tikur Anbessarnspecialized Hospital.rnMethod: In this institutional based prospective cohort study total of 60 ASA I and ASA II age ofrn1-7 years pediatrics patient undergo infra-umbilical surgery that fulfill inclusion criteria wasrnincluded. Systematic random sampling technique was applied & they grouped based on theirrnexposure status. Severity of postoperative pain was measured by FLACC score, duration ofrnanalgesia and total analgesic consumption was assessed up to 24 hours after operation.rnPostoperative pain severity & total analgesic consumption was analyzed by Mann-Whitney Urntest. Independent sample t test was used for analgesia duration as well as Chi-square test wasrnused to analyze categorical variables and p value less than 0.05 was considered as statisticallyrnsignificant. rnResult data of 60 patients were analyzed and the result shows postoperative pain severityrnpresented in median in CB with bupivacaine & IV dexamethasone group was 1.5, 3,6 & 3, 6, 6rnin CB with bupivacaine alone group at 4rnthrn, 6rnthrn & 12rnthrn hours with p value of (