Background: Peripheral nerve block causes sympathetic block with resultant improvement in blood flow hence lessen postoperative vasospasm, tissue anoxia, pain edema which is more favourable in acute hand and reconstructive surgery. Peripheral nerve block remains a well accepted component of comprehensive anesthetic care since Hall first reported the use of cocaine to block upper extremity nerve in 1884. Objectives: To compare the postoperative analgesia following supraclavicular brachial plexus block with Tramadol or Dexamethasone as an adjuvant to bupivacaine in elective upper extremity surgery. Methodology: Total 60 patients of ASA I and II undergoing upper extremity surgery under brachial plexus block with Bupivacaine were randomly divided in to two groups; group A received Tramadol (2mg/kg) and group B received Dexamethasone (0.15mg/kg) as an adjuvant to Bupivacaine. The duration of postoperative analgesia was recorded in both groups using pain VAS score which was determined by maximum VAS score of 8-10 and when patient demands for additional analgesics. Results: The mean duration of postoperative analgesia in the Dexamethasone group was 1023.87 + 161.01 minutes while in the tramadol group it was 454.47 ± 44.29 minutes. Conclusion: Dexamethasone with local anaesthetic prolongs postoperative analgesia significantly than Tramadol (P<0.05) when used as admixture to local anaesthetic in brachial plexus block in upper extremity surgery.