One hundred eleven patients undergoing foot and ankle surgery were randomized to receive a popliteal and saphenous nerve block with liposomal bupivacaine plus 0.75% bupivacaine or liposomal bupivacaine combined with dexamethasone and 0.75% bupivacaine. The primary outcome of interest was postoperative opioid consumption and duration of analgesia. Secondary outcomes of interest included pain scores, use of additional analgesics such as ketorolac, acetaminophen, and Toradol, and sensory changes following the nerve block. Outcomes were assessed at 7 and 14 days postoperatively. Overall, the results of the study revealed that the addition of dexamethasone significantly prolonged the duration of the nerve block and reduced ketorolac use by postoperative day 14, although pain scores and opioid consumption were similar between groups. These findings suggest that dexamethasone may enhance the duration of regional anesthesia when used with liposomal bupivacaine in foot and ankle surgery.