Purpose of Review <p>This paper aims to review the evidence supporting the use of spinal anesthesia (SA) for spinal surgery, highlighting its benefits and addressing the technical challenges and considerations. The goal is to provide practical guidelines to help anesthesia providers feel more comfortable offering SA as an option for appropriate cases.</p> Recent Findings <p>Recent research indicates that SA may offer several benefits for spinal surgery, including better immediate postoperative analgesia, decreased intraoperative blood loss, and faster operating room egress. However, the evidence on hemodynamic stability, postoperative nausea and vomiting, and overall hospital length of stay is mixed.</p> Summary <p>SA presents a viable alternative to general anesthesia (GA) for specific spinal surgeries, offering distinct benefits. Patient selection is crucial, especially for those with cardiovascular risks or airway management challenges. Proper choice of spinal medication and adjuncts, along with meticulous planning for airway management, is essential. Further research will continue to refine the use of SA in spinal surgery, enhancing patient outcomes and expanding anesthetic practice.</p>