Background: Perioperative anxiety is a significant concern affecting patient outcomes and satisfaction, and approximately 60% to 80% of adult patients encounter perioperative anxiety. This study was conducted to evaluate effect of music therapy on perioperative anxiety, sedative requirements and hemodynamic parameters in patients undergoing gynaecological surgery under regional anaesthesia. Materials and Methods: This prospective observational study was conducted from July 2023 to June 2024. Study included 67 patients aged 18-60 years, with ASA CLASS I, II and III, scheduled for gynecological surgery under regional anesthesia. Patients were distributed into Group M (patients who opted for listening music during surgical procedure) and Group C (patients who did not opt for music therapy). Validated tools like State trait anxiety inventory score (STAI) and visual analogue scale- anxiety (VAS- A) were utilised to assess perioperative anxiety, and intraoperative sedative requirement was titrated using ramsay sedation score (RSS). Patient’s hemodynamic parameters, RSS and need for midazolam for maintenance of sedation were recorded every 15 minutes intraoperatively. Data thus collected was subjected to statistical analysis and results were drawn. Results: Intra-group comparison showed that in post-operative period, STAI-SA and VAS-A scores were significantly lower compared to pre-operative period in both groups (p<0.05). Inter-group comparison showed that post-operative STAI-SA and VAS-A scores, as well as dose of Midazolam required to maintain RSS of ≥3 were significantly lower in Group M as compared to Group C (p<0.05). Conclusion: Music therapy demonstrates promise as an adjunctive therapeutic modality for managing perioperative anxiety during gynaecological surgery.