Abstract: Objective To compare efficacy and side effects of patient-controlled epidural analgesia (PCEA) with levobupiva-caine, ropivacaine and racemic bupivacaine after cesarean section. Methods In this prospective,randomized double-blind study, 90 ASA Ⅰ-Ⅱ full-term nulliparous women (aged 25-38 years with body weight of 59-87 kg) undergoing elective cesarean section under spinal-epidural anesthesia equally allocated into 3 groups. PCEA was administered with 0.125% levobupiva-caine and 20 μg/ml morphine (group L, n=30), 0.125% ropivacaine and 20 μg/ml morphine (group R, n=30), and 0.125% bupivacaine and 20 μg/ml morphine (group B, n=30), respectively. The Visual Analog Scale (VAS) score, satisfaction rate, patients’ overall impression of treatment, modified Bromage motor score, and incidence of side effects were recorded at regular intervals after operation. Results The three groups were comparable with respect to the efficacy of analgesia, patients’ overall impression of treatment, motor blockade and side effects. There was significant difference in patients’ satisfaction rate between group R (70%) and the other two groups (93.3% in group L and 96.6% in group B, P<0.05). Conclusion PCEA with 0.125% levobupivacaine and morphine 20 μg/ml produces better analgesic effect with little side effects after cesarean section.