The median nerve block is a regional anaesthesia technique used primarily for forearm and hand surgeries. Originating from the brachial plexus (C5-T1), the median nerve travels alongside the brachial artery before crossing the antecubital fossa and descending between the flexor digitorum superficialis and profundus muscles. It provides sensory innervation to the palmar aspect of the thumb, index, middle, and lateral ring fingers and motor control of the thenar muscles and lateral lumbricals. This block is commonly performed for distal forearm and hand procedures, mainly when upper arm tourniquet analgesia is unnecessary. It can also serve as a rescue block for failed proximal anaesthesia. Ultrasound guidance enhances precision by identifying the nerve medial to the brachial artery at the antecubital fossa or between the flexor muscles in the mid-forearm. The block can be performed using either in-plane or out-of-plane needling techniques, with nerve stimulation confirming proper placement via finger flexion response. Compared to proximal blocks, the median nerve block preserves proximal limb function, making it ideal for procedures where upper limb mobility is desired. It is a safe and effective technique with minimal complications when performed correctly.