Background:  Spinal surgery in adults can vary from simple to complex and can also have variable anticipated surgical blood loss. There are several factors that can put patients at increased risk for greater intraoperative blood loss. This study aimed to compare between total intra venous anesthesia (with propofol) and inhalational anesthesia (with isoflurane) on the quality of surgical field in spine surgery. Patients & Methods: A prospective comparative randomized clinical study for comparison between total intra venous anesthesia (with propofol) and inhalational anesthesia (with isoflurane) on the quality of surgical field and hemodynamics of patients in spine surgery. Thirty patients in the age group of 21–50 years with ASA physical status Classes I and II, undergoing spine surgery were randomly divided into two equal groups of fiften each. In Group S: received isoflurane-based inhalational anesthesia and in Group P: were administered TIVA with propofol. All patients in both groups were assessed for: hemodynamics (heart rate,mean arterial blood pressure), respiratory profile ( SpO2 %, end tidal CO2), surgical field rating scale, surgeon satisfaction, total blood lost and amount of transfused blood during surgery. Results: Regarding mean blood pressure, it was less in group P than group S. Regarding heart rate values, it was less in group P than group S .Regarding total blood loss, it was more in group S .Group P had better surgical field rating than group S. The surgeon operating on the group receiving propofol had better satisfaction. There were no significant differences between the studied groups regarding ETCO2 and SpO2 over time. Conclusion: In spine surgery, using TIVA with propofol provides better hypotensive anesthesia, decreases blood loss during surgery and also provides good quality of surgical field as compared to using inhalational anesthesia with isoflurane.