Background: Insufficient surgical pain management can hinder healing, raise healthcare expenses, and decrease patient satisfaction. According to some investigations, spinal bupivacaine-dexamethasone showed analgesic effects that were nearly as potent as those of bupivacaine-fentanyl while also having opioid-sparing and antiemetic properties. The optimal spinal dexamethasone dosage for postoperative analgesia has not yet been established. It was therefore required to conduct a study looking at the effectiveness and safe amount of spinal dexamethasone for postoperative analgesia in patients having abdominal hysterectomy. Aim: Optimizing post-operative analgesia using two different doses of intrathecal dexamethasone added to bupivacaine in patients undergoing abdominal hysterectomy. Patients and methods: This study was conducted on patients who underwent elective abdominal hysterectomy at Zagazig University Hospitals' Department of Anaesthesia, Intensive Care, and Pain Management. The patients were divided into 3 groups (43 subjects each): Group C (Control group) received intrathecal bupivacaine 0.5% 4 cc plus 1 cc normal saline, group D2: received intrathecal bupivacaine 0.5% 4 cc plus 2 mg dexamethasone in 1cc volume and group D4 received intrathecal bupivacaine 0.5% 4 cc plus 4 mg dexamethasone in 1cc volume. Results:In terms of post-operative discomfort, there were statistically significant differences between groups C and D4 at various follow-up intervals. Also, between groups D2 and D4 from 0 to 12 hours after surgery. Conclusion: In women having abdominal hysterectomy surgery, intrathecal dexamethasone 4 mg combined with bupivacaine increased the intensity and duration of post-operative analgesia without causing any negative side effects.