Combined spinal-epidural (CSE) anaesthesia is a widely used neuraxial technique that provides rapid onset spinal anaesthesia followed by prolonged analgesia via an epidural catheter. It is commonly used in obstetric anaesthesia, orthopaedic procedures, and significant abdominal or vascular surgeries. The technique can be performed using the needle-through-needle (NTN) or separate-needle (SN) approach, each with advantages. CSE combines the reliability of spinal anaesthesia with the flexibility of epidural analgesia, allowing for dose titration and extended pain relief. Common complications include hypotension, post-dural puncture headache (PDPH), catheter misplacement, and neurological injury. Careful patient selection and ultrasound guidance enhance safety and efficacy.