Background: intravenous regional anesthesia (IVRA) was first described almost a century ago by August Bier and has been used for the past 50 years. It is a safe anesthetic technique for upper or lower distal limb surgery. Purpose: to compare the onset time of sensory blockade when adding ketorolac versus adding magnesium to the IVRA solution, and to compare the duration of postoperative analgesia. Material and Methods: this is a randomized controlled trial in two groups. The study was performed in Ain Shams University Hospitals. Study period range was 1-2 years. Results: there are 146 patients participated in our study, patients were allocated to two groups 73 patients in each group, a group of which received magnesium sulphate solution and the other received ketorolac solution. Conclusion: we evaluated the effects of adding ketorolac and compared it to the effects of adding magnesium sulphate to the anesthetic solution used in IVRA and we found that magnesium sulphate addition can be of benefit in faster onset of sensory block in the operative limb. However, magnesium sulphate in the used concentration (10 ml MgSo4 10% in 40 ml solution) appeared to cause burning pain varying in intensity while injecting the anesthetic solution.