Axillary brachial plexus blockade is a versatile technique that can be used to provide anesthesia and analgesia of the arm below the shoulder. This report describes the use of a bullet-tipped catheterover-the-needle device in combination with a peripheral nerve stimulator for performing axillary brachial plexus block. This technique has distinct advantages over other techniques commonly used. They include a set of very distinct insertion endpoints, potentially decreased risk of vascular or neural trauma from the blunt needle, an insulated needle that may be used with a peripheral nerve stimulator to confirm entry into the sheath, a more proximal delivery site for local anesthesia due to the 6.6 cm length of the catheter, and a ready means of providing prolonged anesthesia or analgesia with the use of the indwelling catheter. In conclusion, this technique represents a valuable addition to the armamentarium of the anesthesiologist providing regional anesthesia/analgesia of the upper extremity.