Background: neuraxial techniques for labor have consistently be used for alleviation of labor pain. The use of combined spinal epidural (CSE) has gained popularity as an alternative to conventional epidural techniques, although several challenges and debate exist regarding its impact on labor progress, mood of delivery and neonatal outcome. Objective: To detect the clinical effects of labor CSE analgesia in terms of analgesic efficacy and degree of motor block and its impact of labor, of delivery and neonatal outcome .