Objective: Since initial description by Forero for thoracic region, ultrasound guided erector spinae plane(ESP) block has experienced several surgeries for postoperative pain management, chronic pain or surgicalanesthesia. Although ESP block has been reported to provide effective analgesia in the thoracic region, itseffect in lumbar region still unclear. In this study we aimed to showed our successful experience with lumbarESP block as a main anesthetic technique in fifteen high risk elderly patients undergoing hip surgery with mildpropofol sedation.Materials and Methods: In this observational study high risk elderly fifteen patients received lumbar ESPblock as a main anesthetic technique with mild propofol sedation. 40 mL of local anesthetic mixture (20 mLbupivacaine 0.5%, 10 mL lidocaine 2%, and 10 mL normal saline) was administered between the erector spinae muscles and transverse process at the level of the 4th lumbar vertebra. Also we demonstrate magneticresonance images and discuss the anatomic basis of lumbar ESP block.Results: All patients’ surgeries were completed without requirement for general anesthesia or local anesthesia infiltration of the surgical site. All patients’ pain scores were <2/10 in the recovery room. Significantcontrast spread was observed between the Th12 and L5 transverse process and erector spinae muscle andbetween multifidus muscle and iliocostal muscle at the L2-4 levels. Contrast material was observed at theanterior of the transverse process spreading to the paravertebral, foraminal and partially epidural area/spacesand also in the areas where the lumbar nerves enter the psoas muscle.Conclusion: Lumbar ESP block when combined with mild sedoanalgesia provides adequate and safe anesthesia in high risk elderly patients undergoing hip surgery.