Background: Subarachnoid block (SAB) is the preferred anaesthetic technique for Caesarean sections due to its rapid onset, safety, and minimal foetal exposure. Patient positioning is critical for successful dural puncture. This study evaluates the efficacy and comfort of a novel sitting position (knee-flexed with a 30 cm pillow under the knees) compared to the conventional sitting position (legs extended) in parturients. Methods: This prospective, interventional, controlled study was conducted at ESI PGIMSR, Manicktala from February 2020 to April 2021, involving 122 ASA II parturients undergoing elective Caesarean section under spinal anaesthesia. Participants were randomly allocated into two groups: control (traditional positioning) and experimental (new positioning with a pillow under the knees). Lumbar interspinous distances at L3–L4 and L4–L5, posterior dura visibility, number of needle passes and attempts, and patient comfort (Likert scale) were recorded. Ultrasonography guided spinal needle placement. Statistical analyses were performed using SPSS v27.0 and JASP v0.11.1. Results: Demographic parameters (age, height, weight, BMI) were comparable between groups (p > 0.05). No statistically significant difference was found in interspinous distances, posterior dura visibility, number of needle passes, or attempts between the two groups (p > 0.05). Comfort during positioning was significantly higher in the experimental group (p < 0.05), although overall procedural comfort did not differ significantly. The new positioning did not reduce lumbar lordosis or improve needle passage success. Conclusion: The novel knee-flexed sitting position with a pillow under the knees provided superior positioning comfort without compromising the technical aspects of spinal anaesthesia. However, it did not significantly improve interspinous space or reduce the number of needle passes or attempts. Further studies with larger, more diverse populations are recommended to validate these findings.