Background: Existing literature data is scarce concerning comparing hypotensive drugs to assess cerebral effects by evaluating rSvO2 (regional cerebral oxygen saturation). Aim: The present study aimed to comparatively assess the effects of nitroglycerin and dexmedetomidine on cerebral oxygen saturation utilizing near-infrared spectroscopy in subjects undergoing controlled hypotensive anesthesia. Methods: The present study assessed adult subjects undergoing head and neck surgeries at the Institute under general anesthesia. Subjects were randomly divided into two groups where one group of subjects was given dexmedetomidine and the other group of subjects was given nitroglycerine infusion for controlled hypotensive anesthesia. The data gathered included perioperative hemodynamics, bilateral rScO2, CDEs (cerebral desaturation events), and NIRS for cerebral oximetry in both groups. Results: Among 164 study subjects assessed in both groups, cerebral desaturation events were seen in 30 subjects each from both groups. A reduction from baseline by 20% was seen in six subjects with two from the nitroglycerine and four in the dexmedetomidine group. The risk of getting cerebral desaturation events was equal among the two groups. The time to cerebral desaturation events was comparable in the two groups with p>0.05. Differences in heart rate showed statistical significance in the two groups with p<0.001. Conclusion: The present study concludes that dexmedetomidine is not inferior to nitroglycerin concerning the occurrence of cerebral desaturation events when used for controlled hypotensive anesthesia in subjects undergoing head and neck surgeries.