Background: Post-aesthetic shivering is a common complication after neuraxial anaesthesia, often managed with agents like tramadol and meperidine, which are associated with adverse effects such as nausea and vomiting. Dexmedetomidine, a centrally acting alpha-2 adrenergic agonist, may offer a safer alternative.Objective: To compare the efficacy of intravenous tramadol and intravenous dexmedetomidine in controlling post-spinal anaesthesia shivering in obstetric patients undergoing caesarean sections.Methods: This quasi-experimental study was conducted from 20 February to 20 August 2024, involving 120 patients undergoing elective cesarean sections who developed post-spinal shivering. Patients were randomly assigned to receive either intravenous dexmedetomidine (0.5 mcg/kg) or tramadol (0.5 mg/kg). Outcomes measured included time to shivering cessation, recurrence, and adverse effects, analysed using independent sample t-tests and Chi-square tests with significance set at p ≤ 0.05.Results: The time to cessation of shivering was significantly shorter with dexmedetomidine (172.12 ± 14.26 seconds) compared to tramadol (278.06 ± 23.17 seconds, p < 0.001). Shivering recurrence was 5% in the dexmedetomidine group versus 16.66% in the tramadol group (p = 0.03).Conclusion: Dexmedetomidine demonstrated superior efficacy in controlling post-spinal anaesthesia shivering with fewer adverse effects compared to tramadol, making it a preferred option in obstetric settings.