Background: Spinal anesthesia is the most popular form of regional anesthesia used for Cesarean delivery. Like all surgical patients, obstetric patients also feel operative stress and anxiety. The pharmacological sedation in spinal anesthesia is not commonly applied. Objectives: This work aimed to determine the effect of premedication with midazolam on preoperative maternal anxiety, neonatal outcome regarding respiratory depressant effect and muscle tone, and also postoperative satisfaction of parturients scheduled for elective cesarean delivery under spinal anesthesia. Patients and Methods: After approval of Institutional ethical committee and obtaining written informed consent from eligible parturient women, 80 full term pregnant patients aged between 18 and 40 years were classified according to American Society of Anesthesiologist I and II and scheduled for elective cesarean section. The study was conducted in the Obstetrics Department of Al-Azhar University Hospitals (Al-Hussein and Bab-Al-Shaarya), from December 2018 till June 2019. Results: Midazolam intravenously at a dose of 0.035 mg/kg before spinal anesthesia for patients undergoing cesarean section were effective in relieving maternal anxiety with no adverse effect on neonates or maternal hemodynamic instability. Conclusion: Preoperative sedation 30 mins pre anesthetichally was found to be associated with improved preoperative anxiety, postoperative satisfaction, and maternal hemodynamics in parturients scheduled for elective cesarean delivery.