Spinal anesthesia in preterm infants offers a safe alternative to general anesthesia, especially if general anesthesia is not preferred because of coexisting diseases, such as bronchopulmonary dysplasia and recurring of apnea. But the single-shot technique of spinal anesthesia has some limitations because the duration of surgical anesthesia is approximately 60 min. Since some procedures may require more time, alternative regional techniques which provide more prolonged surgical anesthesia are needed. We present our experience with a combined spinal caudal anesthesia in a preterm infant.