Objectives: Abdominoplasty is a very common surgery nowadays and mainly performed as an office-based procedure. Spinal anesthesia is assumed to be safer than general anesthesia in such operations. The aim of this study is to compare between spinal and general anesthesia for abdominoplasty. Patients and Methods: Two hundred patients undergoing abdominoplasty, American Society of Anesthesiologists physical status classes I and II, were enrolled in this randomized prospective study. One hundred patients were operated upon under general anesthesia (Group G) and another one hundred patients under spinal anesthesia (Group S). Any intraoperative complications such as hypotension, bradycardia, pain, shivering, nausea, and vomiting related to anesthesia were managed and recorded. Visual analog scale was used to assess postoperative pain severity and the need for analgesia to be administered till 12 h postoperatively. Results: There was no significant difference as regards patient's satisfaction in both groups although it was lower in Group G than in Group S. There were significant differences in between both groups as regards postoperative nausea and vomiting, early demand for analgesic and total dose of pain killer consumed in 12 h postoperatively which were higher in Group G than in Group S. Conclusion: Spinal anesthesia can be an effective anesthetic technique for office-based abdominoplasty with less postoperative complications when compared with general anesthesia for short procedures with no extensive dissection and positioning.