Background : Regional anesthesia is being practiced safely with reduced risk. The aim of our study was to compare the efficacy of Ketorolac in different doses as adjuvants to Lidocaine in intravenous regional anesthesia (IVRA) (Bier's block). Patients and Methods : This is a randomized double-blind controlled study which was conducted in the Department of Anesthesia, Kasr Al Einy Teaching Hospital, and Cairo University, Egypt. Seventy six patients, aged 20-50 years, ASA I-II, both genders, scheduled for minor forearm and hand surgeries under IVRA were enrolled in the study. The patients were randomly allocated into four equal groups: group GL (n = 19) received lidocaine in IVRA, group GKr10 (n = 19) received lidocaine and Ketorolac 10 mg mixture, group GKr20 (n = 19) received lidocaine and ketorolac 20 mg mixture and group GKr30 (n =19) received lidocaine and ketorolac 30 mg. The onset of both sensory and motor blocks, time to first call for analgesic postoperatively, and complications related to the drugs or technique were recorded.Results : There was a statistically significant acceleration in the mean onsets of sensory and motor blocks in groups GKr10 , GKr20 and GKr30 compared with group GL (P < 0.001). The results observed in the three groups were comparable. In addition, there was an increase in the meantime to first call for analgesic in group GKr10 group GKr20 and GKr30 compared with group GL (P < 0.001). Group GKr30 had the longest duration of postoperative analgesia and this been statistically significant compared with other groups (P < 0.001). There were minimal and non-significant complications. Conclusion : The use of Ketorolac as adjuvants to Lidocaine in IVRA resulted in significant acceleration of the onsets of both sensory and motor blocks, improved post-operative analgesia and no complications.