Background: Ultrasound-guided together with the use of nerve stimulator in peripheral nerve block for correct needle placement and local anesthetic spread monitoring around the nerves helped to reduce the volume of local anesthetic (LA) required and achieve high success rate. Objective: Determination of an effective volume of 2% xylocaine with epinephrine (1: 200,000) for ultrasound and nerve stimulator guided axillary brachial plexus block (ABPB). Patients and Methods: Sixty patients who had plastic distal forearm and hand surgeries underwent a single-shot axillary brachial plexus block were enrolled in a prospective randomized clinical trial. Patients were randomly divided into three equal groups, according to the proposed injection volume of study medication LA; 2% xylocaine with epinephrine 1: 200,000 concentrations per nerve. Group I (received 5ml of study medication), group II (received 3 ml of study medication) and group III (received 1.5 ml of study medication).  Results:  Sixty patients were blindly randomized into 3 groups, four patients did not complete the study and 56 patients were included in the analysis. The mean sensory and motor block duration respectively were 278.8 & 208.6±35.4 minutes in group I, 221&168.6±23.5 minutes in group II and 165.4&138.8±18 minutes in group III respectively with highly statistical significance between group III and both groups I and II. Statistical analysis did not show any significantly difference regarding sensory and motor onset block duration between and among the three groups. No adverse effects were reported during and after the block in all groups. Conclusion: The current study showed highly statistically significance as regarding the total sensory & motor block durations when used volumes 5ml and 3ml VS 1.5ml per nerve of LA; 2% xylocaine with epinephrine 1: 200,000 in ABPB. Also, the present study showed that there was a higher success rate without statistical difference regarding the sensory and motor onset time in these different volumes of local anesthetics together without reported adverse effects when combination of ultrasound-guided and nerve stimulator used in axillary brachial plexus nerve block.