Background: The current study explored the safety of adding low dose atracurium to lidocaine, bupivacaine and hyaluronidase mixture in percaruncular peribulbar anesthesia for high myopes undergoing phacoemulsification.Methods: 82 ASA-PS I-III patients scheduled for phacoemulsification with high myopia were enrolled in this randomized controlled double-blinded trial. The enrolled patients were randomly allocated to one of two groups. Group C (n=41) received 2.5ml of lidocaine 2%, 2.5ml of bupivacaine 0.5% with hyaluronidase 15IU/ml and 1ml normal saline, while patients in Group A (n=41) received the same mixture with 5mg atracurium. Patients' hemodynamics, peripheral O 2 saturation, occurrence of intraoperative pain and incidence of were recorded.Results: There were no major complications in any of the 82 cases. The incidence of minor complications between both groups were comparative. Chemosis occurred in 12.2% of Group A and in 24.3% of Group C. Sub-conjunctival hemorrhage occurred in 4.9% of patients of both groups. Local hyperemia were only observed in Group A (7.3%) with no statistical significance. Conclusion:Adding 5mg atracurium to LA solution did not increase the incidence of complications in percaruncular block in high myopes.