Abstract: Background: Spinal anesthesia is most preferred method of anesthesia in both emergency and elective caesarean deliveries. It helps reduce complications related to general anesthesia but it has spectrum of complications, most common being hypotension due to sympathetic blockade. Perfusion index greater than 3.5 is associated with higher incidence of post spinal hypotension. Preloading and coloading of crystalloid have been studied and showed different results, this study compares preloading and coloading in patients with PI>3.5.