The combined spinal–epidural technique (CSE) has attained widespread popularity for patients undergoing major surgery below the umbilical level who require prolonged and effective postoperative analgesia. Among the favorable circumstances, this strategy can achieve rapid begin, profound regional blockade with the advantage to change the block. An assortment of procedures and gadgets have been proposed for Combined spinal– epidural Anesthesia. It joins the best highlights of spinal barricade and epidural bar and keeps away from their separate inconveniences. This review focuses on points of interest of combined spinal–epidural anesthesia. Needle-through-needle, Separate needle, Double-barrelled needles as strategies of CSEA has likewise been examined.