Brachial plexus block is a very reliable method of anesthetizing the upper extremity. This review covers recent investigations and case reports concerning the various techniques for producing anesthesia at the level of the brachial plexus. The clinical applications of brachial plexus block have broadened to include continuous techniques for postoperative analgesia as well as prolonged sympathetic nerve block to produce vasolidation. Advantages and disadvantages differ for each of the common approaches to the brachial plexus. Methods for ascertaining correct placement of the needle tip within the confines of the fascial sheath that envelops the plexus may yield varying success rates and complications. Choice of local anesthetic mixture is important in determining onset and duration of the block. Plasma concentrations of the local anesthetics and their metabolites are low when this block is compared to the other regional anesthetic techniques, but this is a very important area of new research. Finally, as with any anesthetic technique, certain complications or extensions of the block's effects may occur. The basis for common side effects and rare complications should be appreciated and treated correctly.