Background: Patients undergoing surgery with spinal anaesthesia often experience significant intraoperative anxiety, which can negatively impact their surgical experience and outcomes. This study aimed to investigate the impact of noise-cancelling headphones and binaural beat music on intraoperative anxiety levels in patients receiving spinal anaesthesia. Methods: This prospective observational study was conducted at a tertiary care hospital over b6 months. Forty-five patients were recruited and randomly allocated to three groups: Group A received noise-cancelling headphones with binaural beat music, Group B received noise- cancelling headphones without music, and Group C (control) received no intervention. The primary outcome was the change in State-Trait Anxiety Inventory-6 (STAI-6) scores from pre- to post-surgery. Secondary outcomes included patient satisfaction, sedation levels, communication difficulty, and hemodynamic parameters.    Results: The group using noise-cancelling headphones with binaural beat music (Group A) experienced a significant reduction in STAI-6 scores, with a mean decrease of 10.6 points (p<0.001). The noise-cancelling headphones alone group (Group B) also showed a smaller, but still significant, decrease of 7.3 points (p<0.001), while the control group (Group C) did not demonstrate a statistically significant change. Patients in the intervention groups reported higher satisfaction scores and required fewer additional anxiolytic medications. Hemodynamic parameters were more stable in the intervention groups compared to the control group. Conclusion: The use of noise-cancelling headphones, particularly in combination with binaural beat music, was effective in reducing intraoperative anxiety and improving patient satisfaction and perioperative outcomes in patients receiving spinal anaesthesia. These non- pharmacological interventions may have important implications for enhancing patient care and experience in the perioperative setting.