Four hundred thirty-three patients with lower limb fractures were randomized to receive either general anesthesia (n=220) or intraspinal anesthesia (n=213). The primary outcome of interest was surgical safety, assessed by comparing postoperative adverse events. Secondary outcomes included anesthesia duration, operative time, length of hospital stay, and laboratory indices such as hemoglobin, serum glutamate pyruvate transaminase, blood urea nitrogen, and creatinine. Outcomes were assessed postoperatively. Overall, the results of the study revealed no significant differences between the two groups regarding anesthesia duration, operative time, length of hospital stay, laboratory indices, or adverse events (P > .05). The findings suggest that both general and intraspinal anesthesia are effective and safe for lower limb fracture surgery, allowing for patient-specific selection of anesthesia methods.