Ｏｂｊｅｃｔｉｖｅ　To compare anesthetic effects and hemodynamic characteristics of spinal anesthesia with combined use of hyperbaric and hypobaric ropivacaine or single hyperbaric ropivacaine in patients undergoing caesarean section.　Methods　One hundred and forty-two patients undergoing elective cesarean delivery with combined spinal-epidural anesthesia were included in this randomized controlled study. The patients meeting inclusion criteria(n=132) were randomly allocated into either the single hyperbaric ropivacaine group(group A) or combined hyperbaric and hypobaric ropivacaine group(group B)， n=66. The primary endpoint was the incidence of hypotension. Secondary endpoints included sensory blockade levels.　Results　Both groups showed similar anesthetic effects. The incidences of hypotension was significantly higher in group A when compared with group B(74% vs 45%)(P<0.05). Group A had a higher incidence of nausea when compared with group B(23% vs 8%)(P<0.05).　Conclusions　Combined use of hyperbaric and hypobaric solution had satisfactory anesthetic effects and more stable hemodynamic characteristics compared with a single dose of hyperbaric solution in caesarean patients with combined spinal-epidural anesthesia.