Background: Breast surgery is an exceedingly common procedure and is associated with an increased incidence of acute and chronic pain in 25–60% of cases. Regional anesthesia techniques may improve postoperative analgesia for patients undergoing breast surgery. Objective: This study aimed to compare the efficacy and safety of an ultrasound-guided Pecs II block versus TPVB for postoperative analgesia after breast surgeries. Patients and Methods: The present study was conducted on sixty female patients ASA I-II, their ages ranged from 18- 65 years old scheduled for unilateral breast surgery. The patients were allocated randomly into two groups (n=30) according to type of regional anesthesia administrated. (PECS block or TPVB). Results: The results demonstrated that PECS block caused hemodynamic stability, decreased the intensity of postoperative pain, reduced postoperative analgesic requirement, prolonged the time needed for first request of analgesia and decreased PONV. Therefore it can be considered as quite safe procedure and effective as well for intraoperative and postoperative pain control in breast surgeries. Conclusion: PECS blocks can produce excellent pain relief during the first twelve postoperative hours. They hold great promise due to their simplicity, easy-to-learn techniques and relative lack of contraindications and complications. It maintained hemodynamic stability. Also, it produced low pain scores and less total (morphine) consumption in the early postoperative period after unilateral breast cancer surgery.