ABSTRACT Objective: to evaluate the effect of combined spinal epidural anesthesia with low dose ropivacaine for labor analgesia in highland. Methods: one hundred of primiparas who were at full term and in spontaneous labor in highland, were assigned randomly in two groups (n=50 each): labor analgesia group (group A) and control group (group B). In group A, 0.1% ropivacaine 3ml were given in spinal when the cervical dilation were 3 cm, then PCEA pump were placed in epidural. And the PCEA pump were withdrawn when the fetus were delivered. In group B, primiparas were not accepted any labor analgesia. BP、HR and the scores of VAS and Bromage were determined before anesthesia and at 5min, 10min, 30min after anesthesia in two groups. Duration of labor, method of delivery, oxytocin dose, maternal satisfaction and amount of bleeding after birth were recorded. The Apgar scores of the neonates were recorded at 1,5 and 10 min after birth. Results: Groups were similar for BP, HR, duration of labor, amount of bleeding after birth, the Apgar scores of the neonates. The VAS score was less in the labor analgesia at 5 min after anesthesia compared with that before anesthesia（p<0.05）. Cesarean section rate and oxytocin dose in group B was significantly higher than that of group A（p<0.05）. Maternal satisfaction rate in group A was significantly higher than group B （p<0.05）. Conclusion: labor analgesia in highland results in less pain rapidly and maternal satisfaction remains high without negative effect on duration of labor and fetus.