Context: There are limited studies indicating the incidence of post operative morbidity and mortality in high risk patients. Urological procedures constitute a major portion of geriatric surgeries where a cardiac complication is almost inevitable and therefore this group was selected for this study purpose. Aims: To compare the incidence of post operative cardiovascular complications during regional and general anesthetic techniques in patients with known cardiac risk undergoing urological surgeries. Settings and Design: Prospective randomized double blind study. Methods and Material; 40 patients aged above 50 years posted for elective urological surgeries were enrolled in the study after obtaining approval from hospital ethics committee and written informed consent from the patients. Patients were divided into two groups A& B. Group A (n=20) received general and group B (n=20) received regional anaesthesia (spinal/ Epidural). All the patients received standard premedication and their basal vitals (BP, HR, ECG pattern) were recorded. The same parameters were monitored in the post operative period at regular intervals. Statistical analysis used: Student "t" test was used to test the significance of statistical difference in the variables between the two groups. Results: The mean heart rate and the mean arterial blood pressure were increased (P<0.01) in the general anaesthesia group. Group A showed 10% incidence of ECG changes and group B showed 35% incidence of ECG changes. But the changes in the hemodynamics were not significant. Conclusions: There is no difference between regional anaesthesia and general anaesthesia regarding the post operative outcome after urological procedures with respect to hemodynamic changes.