Dexmedetomidine (DEX) has analgesic, sedative, and anesthetic-sparing effects. DEX, as an adjunct to local anesthetic, has evoked a special interest in pain control. This work aimed to assess the impact of the addition of DEX to levobupivacaine in neuraxial anesthesia and sedation changes versus levobupivacaine alone in patients planned for lower abdominal surgeries. Methods: This randomized controlled study was carried out on 58 patients aged from 28 and 56 years old, both sexes, I, II, III American Association of Anesthesiology (ASA) physical status scheduled for lower abdominal surgeries lasted for maximum duration 2hrs. Patients were categorized into 2 equal groups; the control group: received 3mL of 0.5% levobupivacaine +0.5mL normal saline, and the combined group: received 3mL of 0.5% levobupivacaine +0.3ml (5μg) DEX maximum duration (1.5-2)hr. Results: The mean time of onset of sensory and motor block was significantly earlier in the combined group compared to the control group. The mean time duration of sensory and motor block was significantly increased in the combined group compared to the control group. The mean time of total duration of sensory block and analgesia was considerably longer in the combined group than in the control group. The quality of recovery was significantly higher in the combined group than in the control group. Conclusions: Adding DEX to intrathecal levobupivacaine reduces the sensory and motor block onset time, prolongs the block duration with no significant adverse effects, and provides adequate surgical anesthesia for lower abdominal surgeries.