Abstract Background: Hip surgeries (Hip fracture and arthroplasty) are the second most common reason why older people are ad-mitted to hospitals, & as the population's mean age rises, it is turning into a serious public health issue. Aim of Study: The goal of this research is to compare con-tinuous spinal anaesthesia versus epidural anaesthesia in geriat-ric studied cases undergoing major hip surgeries (hip fractures and hip replacement). Patients and Methods: In Al-Azhar University Hospitals (Assuit), sixty studied cases older than sixty years old who were scheduled for major hip surgery & classified as class II or III by the American Society of Anesthesiologists participated in this randomized, double-blind comparative trial. Studied cases had been randomly assigned to 2 equal groups: Group I consisted of thirty studied cases who received continuous spinal anesthesia, & Group II consisted of 30 studied cases who received contin-uous epidural anesthesia. Results: Both methods provide effective methods of anes-thesia for elderly studied cases undergoing major hip surgeries, with no difference in the intraoperative and postoperative com-plications. Conclusion: In conclusion, this comparative study demon-strates that both continuous spinal anesthesia & continuous epidural anesthesia have been effective methods for providing surgical analgesia in elderly studied cases undergoing major hip surgery, with similar performance times and durations of surgical analgesia.