This study was done to assess the efficacy of combining dexamethasone with nalbuphine to bupivacaine 0.25% for BPB regarding the beginning of sensory and motor block, duration of motor block and postoperative analgesia, the total fentanyl consumption in the first 24 hours and any associated complications, From the results of our study, we can conclude that the addition of 10 mg of nalbuphine hydrochloride with 4 mg of dexamethasone to bupivacaine 0.25% in brachial plexus block has the advantages of extending the duration of postoperative analgesia and reducing postoperative opioids requirements while preserving early recovery of motor function when compared to bupivacaine 0.5%.