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At Olympias Underground Mine, drift-and-fill mining under the cemented paste backfill is required for the safe and effective recovery of sill pillars within complex geology and variable ground conditions. Cured cemented paste backfill provides critical confinement to the surrounding rock, enabling controlled blasting and reducing the risk of instability during mining. This case study reviews operational practices and design considerations specific to Olympias Mine, including geomechanics and geotechnical aspects of mining with paste backfill, paste fill strength requirements and quality control, curing times, blast sequencing, and the integration of ground support systems.