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Background and Aims Mortality rates following general anaesthesia in low and middle-income countries (LMICs) remain high, largely due to a lack of qualified anaesthesia providers and limited resources. One approach to reducing anaesthesia-related mortality in LMICs is promoting regional anaesthesia techniques. While spinal anaesthesia is commonly practiced, upper limb nerve blocks are rarely taught or performed.Methods The first regional anaesthesia course in Sierra Leone (SL) was piloted at Masanga Hospital, aiming to train nurse anaesthetists to perform axillary brachial plexus blocks (ABPBs) independently. The planning phase involved breaking down the ABPB into its component parts, standardising each step, and ensuring the required drugs and equipment were available in SL.Results The teaching program ran over two weeks, delivered by UK and SL anaesthetists. Week one focused on skill development, using various learning techniques to make the training engaging while accelerating the learning process. Topics included ultrasound principles, needling techniques, and ABPB procedure. The second week provided hands-on experience, with participants performing supervised ABPBs on patients undergoing surgery for burn contractures, invited to Masanga as part of the course. Between cases, participants engaged in simulation-based teaching on local anaesthetic toxicity and other emergencies. By the end, each trainee had successfully performed an ABPB either independently or with peer-led supervision.Conclusions The course demonstrated the feasibility of introducing upper limb regional anaesthesia techniques in LMICs. One challenge encountered was the lack of appropriate ultrasound probes in Sierra Leonean hospitals. Fundraising to acquire suitable probes will be a priority before running the course again.