Epidural anesthesia is a high-precision clinical procedure that requires inserting a Tuohy needle based on the anesthesiologist’s tactile perception, without direct visualization of internal structures. This “blind” approach increases the risk of complications, especially in the early stages of training. This work presents the development of a mixed-reality visual-haptic assistance system that integrates a real Tuohy needle, a haptic device, and projected virtual elements to guide the user during epidural insertion. The system includes a test bench with 3D-printed L1-L2 vertebrae immersed in ballistic gel. A portable ultrasound machine identifies the intervertebral space and calculates the insertion orientation and depth. With this information, two spatially registered virtual elements are projected: an insertion cone, which defines the ideal point and angle, and a depth cylinder, which represents the safe limit of insertion. Both interact with the physical needle manipulated through the haptic device, generating real-time restrictive forces if collision or over insertion is detected. A proof-of-concept with users showed that, without virtual assistance, the needle exceeded the epidural space; while, with mixed guidance, the user accurately reached the anatomical target. These results highlight the system’s potential as an intraoperative support tool to enhance safety and precision in epidural procedures.