Background: peripheral nerve blocks were introduced to offer analgesia in hip surgery. Objective: This study compared the analgesic efficacy of combined lateral femoral cutaneous nerve (LFCN) block with pericapsular nerve group (PENG) block versus fascia iliaca block (FIB) for proximal femur surgery. Patients and Methods: One hundred patients underwent proximal femoral fracture surgeries were equally randomized to either group І: FIB or group ІІ: combined LFCN block with PENG block. The primary outcome was how long it took to perform spinal anesthesia. The secondary outcomes were the assessment of sensory block, VAS during spinal anesthesia, anesthesiologist satisfaction, time to first analgesic request, postoperative pain score and total morphine requirements. Results: The VAS scores did not significantly differ from one another during positioning for spinal anesthesia between two groups. After 15 minutes and 30 min of blocks, VAS score at rest was reduced in group ІІ compared to group І but with no significant difference. The median (VAS) score at rest immediately and one hour at post anesthesia care unit (PACU) was significantly lower in group ІІ compared to group І. Time to first analgesic request, total morphine consumption in the postoperative 24 hours (h) showed no significant statistical difference between both groups.  Conclusions: PENG block is an effective and safe practice that could be an alternative to FIB for pain relief and comfort during positioning in patients with proximal femur fractures with preservation of motor function.