Shivering, an involuntary skeletal muscle activity, commonly triggered by hypothermia, poses challenges in the perioperative period, affecting postoperative recovery. Pharmacological interventions, including opioids and 5-HT3 receptor antagonists, aim to alleviate shivering. Ondansetron, a first-gen antiemetic, has demonstrated efficacy in preventing shivering in diverse surgeries. Palonosetron, a newer 5-HT3 antagonist with an extended half-life and higher receptor affinity, holds promise but lacks conclusive evidence. While Ondansetron’s effectiveness is supported by studies in cesarean section and hernia repair, direct comparisons with Palonosetron are limited. Insights from studies on serotonin receptor antagonists, like ramosetron, offer relevant information. Considering the context of Transurethral Resection of the Prostate (TURP), understanding its complications, management, and procedural outcomes is crucial. Although literature predominantly features Ondansetron, a gap exists in direct comparisons between Ondansetron and Palonosetron in preventing shivering during TURP under spinal anesthesia. Further research specific to TURP patients is essential for conclusive evidence on the comparative efficacy of these medications. Hence this study aimed to compare the efficacy of ondansetron and palonosetron in preventing Post-Anesthesia Shivering (PAS) in patients undergoing TURP procedures under spinal anesthesia. Shivering, characterized as an involuntary and repetitive activity of skeletal muscles, is primarily triggered by hypothermia but has also been documented in normothermic patients. The etiological mechanisms involve hypothesized pathways mediated by uninhibited spinal reflexes, postoperative pain, and hyperactive sympathetic activities. Variations in the frequency and patterns of shivering are observed across different anesthesia modalities.