Background: Patient positioning for performing spinal blockade causes severe pain in hip and femur fracture. Adequate pain relief before administrating spinal blockade will increase patient's cooperation. This study was done to assess analgesic effect of fascia iliaca compartment block (FICB) for positioning for spinal anesthesia as well as postoperative analgesia in comparison with intravenous fentanyl.  Materials and Methods: This was a randomized, double blind, controlled prospective study that included 66 patients of the American Society of Anesthesiologists physical statuses I to II, of either sex, between 30 and 70 years, posted for hip or proximal femoral surgery, with visual analogue scale (VAS) >4 in preoperative period. The two groups were assigned randomly. In Group A, patients received I/V Fentanyl 100mcg and in Group B, FICB was given half an hour before shifting the patients in operation theater with 30 ml of 0.25% bupivacaine. Each group included 33 patients. Thirty minutes after FICB, spinal anesthesia was given and patients’ vitals were monitored before and after block, at the time of positioning for spinal anesthesia, intraoperative and postoperative periods.