Background: Dexmedetomidine is known for its efficacy as a local anesthetic adjuvant. Herein, we studied the beneficial impact of adding dexmedetomidine to bupivacaine in combined intercostal and pararectus block in patients scheduled for abdominoplasty. Patients and methods: This prospective research enrolled 66 patients allocated into two groups; Group I included 33 patients who received combined intercostal and pararectus blocks using bupivacaine plus dexmedetomidine, and Group II included the remaining participants who received the same blocks using bupivacaine alone. Results: All preoperative patient demographic and clinical criteria expressed no significant difference between the two groups. Group I showed a significant decline in opioid requirements throughout the first postoperative day. The time to the first analgesic request showed a significant delay in Group I (14.73 vs 7.39 hours in Group II). Pain scores showed a significant decline in Group I during rest, cough, and movement, compared to Group II.  O₂ saturation, heart rate, and mean arterial pressure showed no significant difference between the two studied groups. Adding dexmedetomidine was not associated with a significant rise in the incidence of postoperative complications. Conclusion: The addition of dexmedetomidine to the local anesthetic agent during intercostal and pararectal blocks is associated with a better analgesic profile. It is associated with lower pain scores and lower morphine consumption without increased associated side effects.