Background: Endoscopic surgeries are minimally invasive surgeries to treat sinus pathologies. The challenges faced by the anesthesiologist are to provide bloodless field of surgery, to maintain hemodynamic stability, and to reduce anesthetic supplementation to facilitate early recovery of the patient. The preferred anesthesia is general with controlled ventilation, stable surgical field, and airway protection with adequate anesthesia. Problems faced during the procedure are to keep the minimum the bleeding during surgery so that a better visibility of the endoscopic magnified surgical field, faster awakening after reversal of general anesthesia, faster return of protective airway reflexes, and optimal postoperative analgesia. Sphenopalatine ganglion block (SPGB) has proven an effective adjuvant to general anesthesia during sinonasal surgery. Reduced bleeding increases visibility and reduces operative time with reduced complications and better results. In our study, SPGB was supplemented with the general anesthesia to evaluate the comfort of operability, opioid supplementation, inhalation anesthetic requirement, and intraoperative and postoperative complications. Materials and methods: Our study is a randomized controlled triple-blind study with 30 patients in each group. In both the groups, general anesthesia was given. In group I, SPGB was given with a 10 mL of 1% xylocaine local anesthetic, and in group II, SPGB was given with placebo. Results: We have observed that there is a reduced intraoperative and postoperative bleeding in group I, the field of vision is better in group I, and fentanyl supplementation and isoflurane consumption was less in group I. The intraoperative and postoperative complications were less in group I. Conclusion: Sphenopalatine ganglion block regional anesthesia is reliable supplementation to general anesthesia in endonasal endoscopic procedures to provide stable surgical field with reduced anesthetic requirement and minimal intraoperative and postoperative complications.