Music is ubiquitous and found in all cultures; it elicits both physiological and psychological responses in its listener. It has been proven that music reduces perception of pain and dosages of anesthetics and sedatives used during surgery. To study the effect spiritual music on perioperative anxiety and hemodynamic parameters in elderly patients undergoing procedures under spinal anesthesia. A prospective, randomized controlled study. Eighty patients fulfilling inclusion criteria were enrolled and randomly divided in two equal groups. Patients were transferred to the operation theater with the spiritual music still being played in Group I, while no music was played in Group C. Under aseptic precautions, neuraxial blockade was performed at L3/L4 interspace. Music was played throughout the surgery in Group I. Intraoperative visual analog scale for anxiety (VASA) was recorded. At the end of the surgery, spiritual music was stopped. The study parameters were recorded. A significant difference in the proportions of male and female candidates between the two groups was calculated using Chi-squared test. Significant differences in the mean VASA scores and blood pressures (systolic blood pressure [SBP] and diastolic blood pressure [DBP]) between the two groups were calculated using Student's t-test. No significant difference was observed between preoperative VASA score (P = 0.29) of both the groups, whereas a significant difference was present in intraoperative (P < 0.01) and postoperative VASA score (P < 0.01) of both the groups. In Group I, requirement for sedative was significantly lower (P < 0.01). Heart rate in Group I was on lower side, suggesting decrease in anxiety. No significant difference was observed in SBP or DBP of the patients of both the groups. Spiritual music can act as a noninvasive, simple, and inexpensive intervention for elderly patients to alleviate perioperative anxiety. It can also reduce the need for sedatives intraoperatively, thereby lowering the risk of side effects.