Background: Laryngoscopy and endotracheal intubation are associated with significant hemodynamic responses, which may lead to complications, especially in high-risk patients. Various pharmacological agents have been used to attenuate these responses. This study aims to compare the efficacy and safety of Dexmedetomidine and Remifentanil in minimizing hemodynamic fluctuations during laryngoscopy and intubation.Materials and Methods: A randomized controlled trial was conducted on 60 adult patients undergoing elective surgeries under general anesthesia. The participants were divided into two groups: Group D (Dexmedetomidine, 0.5 µg/kg IV over 10 minutes) and Group R (Remifentanil, 1 µg/kg IV over 60 seconds), administered before induction. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline, post-induction, during laryngoscopy, and at 1, 3, and 5 minutes after intubation. Adverse events such as bradycardia, hypotension, and respiratory depression were monitored.Results: At 1-minute post-intubation, Group D showed a 20% reduction in HR compared to a 15% reduction in Group R (p = 0.04). SBP decreased by 18% in Group D versus 12% in Group R (p = 0.03). A similar trend was observed in DBP and MAP. The incidence of bradycardia was 15% in Group D compared to 8% in Group R, while hypotension occurred in 12% of Group D and 6% of Group R. No significant respiratory depression was observed in either group.Conclusion: Both Dexmedetomidine and Remifentanil effectively attenuated hemodynamic responses during laryngoscopy and intubation. However, Dexmedetomidine provided better hemodynamic stability but was associated with a higher incidence of bradycardia and hypotension. Remifentanil demonstrated a slightly milder attenuation but with fewer side effects, making it a suitable alternative in patients prone to hemodynamic instability.