Introduction: The neuromuscular blocking agent plays an essential role in balanced anaesthesia, and the introduction of skeletal muscle relaxants has revolutionised the field of anaesthesia and critical care. Atracurium and Cisatracurium, intermediate-acting, benzylisoquinoline non depolarising neuromuscular blocking agents. These drugs have fewer side effects, and organ-independent elimination has made it the most commonly used neuromuscular agent. The present study is designed to evaluate the adverse reactions of both drugs, as well as their safety profile and economic benefits. Methods: A prospective randomized comparative study was done in the Department of Anaesthesiology, Shri. B.M. Patil Medical College, Hospital and Research Centre, Vijayapura After obtaining written informed consent and approval from the institutional ethical clearance committee, 140 patients who were scheduled to undergo elective surgery under general anaesthesia with endotracheal intubation and required intraoperative non depolarising neuromuscular blockers were included in the trial. The patients who were a part of the trial were randomly split into two groups. Group A: 70 patients receiving atracurium 0.5mg/kg. Group B: 70 patients receiving 0.15 mg/kg. After induction, hemodynamic parameters and adverse drug reactions like bradycardia, tachycardia, hypertension, hypotension, flushing, collapse, hyperthermia, wheezing, bronchial secretion, bronchospasm, laryngospasm, dyspnea, apnea, erythema, Itching and urticaria were noted. The groups were compared using Wilcoxon-Mann-Whitney U or Chi-square tests as applicable; a p-value <0.05 was considered significant. Results: The average mean cost of the atracurium group is 245.98 INR, and cisatracurium is 439.54 INR with a p-value of 0.001, statistically significant that atracurium is cost-effective compared with cisatracurium. In terms of side effects and hemodynamics like wheezing, hypotension, hypertension, tachycardia, and bradycardia are statistically insignificant with p-values> 0.05, and both groups do not have comparable side effects. Conclusion: Both drugs have a similar safety profile, and cisatracurium is a better choice for patients with hemodynamic instability and those with a risk of histamine related disorders like asthma and anaphylaxis. In terms of economic benefit, atracurium is a better choice.