Background: Dexmedetomidine is known for its efficacy as a local anesthetic adjuvant. Herein, we studied the beneficial impact of adding dexmedetomidine to bupivacaine in combined intercostal and pararectus block in patients scheduled for abdominoplasty. Patients and methods: This prospective research enrolled 66 patients allocated into two groups; Group I included 33 patients who received combined intercostal and pararectus blocks using bupivacaine plus dexmedetomidine, and Group II included the remaining participants who received the same blocks using bupivacaine alone. Results: All preoperative patient demographic and clinical criteria expressed no significant difference between the two groups. Group I showed a significant decline in opioid requirements throughout the first postoperative day. The time to the first analgesic request showed a significant delay in Group I (14.73 vs 7.39 hours in Group II). Pain scores showed a significant decline in Group I during rest, cough, and movement, compared to Group II. O2 saturation, heart rate, and mean arterial pressure showed no significant difference between the two studied groups. Adding dexmedetomidine was not associated with a significant rise in the incidence of postoperative complications. Conclusion:The addition of dexmedetomidine to the local anesthetic agent during intercostal and pararectal blocks is associated with a better analgesic profile. It is associated with lower pain scores and lower morphine consumption without increased associated side effects.