Background: Post-anesthetic shivering is a common complication following general anesthesia. This randomized, double-blind, placebo-controlled trial compared the efficacy of dexmedetomidine versus tramadol in preventing post-anesthetic shivering. Methods: 120 patients undergoing general anesthesia were randomly assigned to receive either dexmedetomidine (1 µg/kg), tramadol (2 mg/kg), or placebo. Shivering incidence and severity, hemodynamic parameters, and adverse effects were monitored post-operatively. Results: The dexmedetomidine group showed significantly lower shivering incidence (15%) compared to tramadol (30%) and placebo (65%) groups (p<0.001). Mean shivering scores were also lower with dexmedetomidine (0.5±0.7) versus tramadol (1.2±0.9) and placebo (2.5±1.1). Dexmedetomidine demonstrated better hemodynamic stability, with lower heart rates (72±8 bpm) and blood pressures compared to other groups. While dexmedetomidine showed higher sedation rates (10%), it had lower incidence of nausea (5%) and vomiting (3%) compared to tramadol (20% and 15% respectively). Conclusion: Dexmedetomidine demonstrated superior efficacy in preventing post-anesthetic shivering compared to tramadol, with a more favourable adverse effect profile. These findings support dexmedetomidine as a preferred agent for shivering prophylaxis following general anesthesia.