Background: Hypotension is one of the major adverse effects seen in patients undergoing spinal anaesthesia and is reported to be seen in more than 30 percent of the cases of patients receiving spinal anaesthesia. It has been highlighted in various studies that the use of atropine and ephedrine in the improvement of hemodynamic parameter when used preoperatively in spinal aesthesia. Hence; we carried this study to evaluate and compare the heart rate and mean arterial pressure after spinal anaesthesia with prophylactic use of atropine, ephedrine and placebo in elderly patients. Materials & Methods:The present study was conducted among 120 patients who underwent surgical procedures under spinal anaesthesia. Patients were randomly divided into three study groups; Group 1 (40 patients): who received normal saline, Group 2 (40 patients) who received 0.6 mg of atropine and Group 3 (40 patients) who received 12 mg of ephedrine. Study drugs were administered to the patients one minute after the spinal anaesthesia. Recording of the various parameters such as amount of vasopressor needed (phenlyephrine), after 15 minutes of spinal anaesthesia, sensory level reached presence of intra-operative angina and intra/postoperative confusion and other side effects till six hours post-surgically was done. All the results were analyzed by SPSS software. Results: MAP at the baseline time in the three study groups was found to be 98.5, 91.5 and 93.7 respectively. 14 patients in