The most common indication for spinal anesthesia in pediatric patients is its use in former preterm infants undergoing bilateral inguinal hernia repairs. Apnea can occur in former preterm patients following a general anesthetic. A number of small studies have confirmed this finding however, there is considerable disagreement regarding the incidence of apnea and the conceptual age at which a former preterm infant may safely undergo general anesthesia on an outpatient basis. Lack of uniformity in study design, small patient population sizes and variations in methodology probably account for the differences. A number of series have been reported in preemies for a variety of surgical procedures attesting to the safety and efficacy of spinal anesthesia. Spinal anesthesia can also be used effectively in children for postoperative pain relief especially if opioids are used. Spinal anesthesia is most commonly used in premature infants who would otherwise require a general anesthetic.