While ERAS protocols have demonstrated benefits in accelerating recovery and ensuring patient safety for Adult Spinal Deformity (ASD) correction, their impact on postoperative analgesic efficacy and comprehensive clinical outcomes remains underexplored. This study aimed to evaluate the perioperative outcomes and postoperative analgesic efficacy of an ERAS protocol in patients undergoing ASD correction. This is a prospective cohort study conducted between March 2021 and December 2024. Seventy-seven ASD patients who underwent posterior-only correction surgery at a single institution were included. Patients receiving the ERAS protocol were prospectively enrolled in the ERAS group (n=40), while those without ERAS were retrospectively identified from institutional databases as controls (non-ERAS group, n=37). The ERAS group demonstrated significantly shorter operative times (359 ± 80 vs. 433 ± 143 minutes, p=0.008) and reduced total morphine sulfate equivalent (MSE) consumption (18.8 ± 20.4 vs. 77.7 ± 51.0 mg, p<0.001) compared to controls. Fewer ERAS patients required patient-controlled analgesia (45% vs. 70.3%). The protocol group achieved an average of 1 day earlier functional recovery, with reduced time to ambulation, oral intake initiation, and catheter removal. Mean visual analog scale (VAS) scores were consistently lower in the ERAS group at postoperative day 1(1.9 ± 1.1 vs. 4 ± 1.2, p<0.001), day 2 (2.0 ± 1.1 vs. 3.4 ± 0.8, p<0.001), and day (2.1 ± 1.2 vs. 3.2 ± 0.8, p<0.001). Hospital stays were also significantly shorter in the ERAS group (9.4 vs. 10.9 days, p=0.005). Implementation of an ERAS protocol for ASD correction surgery significantly improves perioperative recovery trajectories, enhances postoperative pain control, and optimizes overall recovery quality. These findings support the standardized adoption of ERAS principles in adult spinal deformity surgery.