Breast surgery is performed for various reasons including simple lumpectomy, mastectomy and wide local excision. Patients undergoing mastectomy have a very high incidence of postsurgical chronic pain syndrome (20%–50%). A comprehensive perioperative analgesia reduces post surgical pain. In present era of ultrasound, various regional anesthesia techniques have been described including paravertebral block, erector spinae block, pectoral interfacial plane block and serratus anterior plane block. There has been some evidence to suggest regional analgesia techniques reduce the incidence of postsurgical chronic pain in patients undergoing mastectomy. Awake breast surgeries under regional anaesthesia with minimal sedation is also being used for high-risk breast surgeries. Recent articles have also suggested some role of regional anesthesia in improving long term outcomes of patients. Considering a variety of regional anaesthetic blocks that are available, one should use one as per surgical requirement and expertise.