BACKGROUND: Hypotension associated with epidural anesthesia for cesarean section is common and serious, despite the use of uterine displacement and volume preload. This study evaluated the role of crystalloid volume preload for prevention of hypotension during epidural anesthesia. METHODS: Forty parturients undergoing elective cesarean section were allocated randomly to receive either no preload (Group II, n=20) or preload with Ringer's lactate solution 1000 ml over 10-15 minutes (Group I, n=20) before epidural anesthesia. Hypotension was defined as a decrease of systolic blood pressure to less than 90 mmHg and to less than 80% of baseline value. Systolic blood pressure and heart rate were measured 2 minutes interval during first 20 minutes after epidural injection. Apgar score, umbilical venous, arterial and maternal arterial blood gas analysis were done. RESULTS: Significant hypotension occured in seven of the twenty parturients in no preload group (Group II) and seven of twenty parturients in Ringer's lactate preload group (Group I). There were no statistical differences in systolic blood pressure, heart rate, amount of used ephedrine, Apgar score, umbilical venous, arterial and maternal arterial blood gas analysis. CONCLUSIONS: Ringer's lactate preload (1000 ml) before epidural anesthesia in the supine tilted parturients did not decrease the incidence or severity of hypotension.