Wide Awake Local Anaesthesia No Tourniquet (WALANT) and Tumescent Local Anaesthesia (TLA) are regional anaesthetic techniques that allow surgical procedures to be performed without general anaesthesia or deep sedation. WALANT is primarily used in hand surgery, eliminating the need for a proximal motor block or tourniquet. It provides intraoperative analgesia and haemostasis utilizing a mixture of lignocaine with epinephrine, often buffered with sodium bicarbonate to enhance patient comfort and efficacy. WALANT is ideal for patients with comorbidities that preclude general anaesthesia and enables real-time surgical assessment, particularly in tendon repairs. Tumescent local anaesthesia involves infiltrating large volumes of dilute local anaesthetic into subcutaneous tissue. It was initially developed for liposuction but is now widely used in plastic, dermatological, and vascular surgeries. TLA provides prolonged analgesia, haemostasis, and volume expansion, facilitating bloodless surgical fields. The technique enhances fat emulsification and minimises systemic toxicity due to slow absorption. Both techniques offer significant advantages, including reduced hospital admissions, lower opioid use, and improved patient recovery. However, safety considerations include local anaesthetic systemic toxicity (LAST), epinephrine-related complications, and fluid overload in TLA. WALANT and TLA continue revolutionizing regional anaesthesia, promoting safer, cost-effective, and efficient surgical care.