In order to evaluate the postoperative analgesic effect of caudal administration of levobupivacaine, plain or in combination with neostigmine, 50 children who underwent medium gravity operations were studied. The children were randomly divided into two groups: Group L received 1 ml/kg of levobupivacaine 0.25% solution via caudal route, while in Group LN the same solution plus 2 μg/kg neostigmine was given. Patients were assessed for analgesia 4, 8 and 24 hours postoperatively with VAS or TPPPS scores depending on their age, and side effects (motor block, nausea-vomit, sedation, pruritus) were recorded. The overall analgesia score was better in 24 hours in LN group (p<0.05), although more patients in group L (p<0.001) received additional analgesia as needed after the first 8 hours postoperatively. Side-effects were minimal and with no difference between the two groups. Conclusively, in patients of this study the regime of caudal levobupivacaine plus neostigmine produced longer analgesia than plain levobupivacaine, and more profound mainly after the first 8 hours postope-ratively.