Objective: This study aims to compare the efficacy and safety of oral clonidine versus oral midazolam as premedication in adults undergoing elective surgery.Methods: A total of 60 patients were randomized into two groups: Clonidine (n=30) and Midazolam (n=30). Hemodynamic parameters, sedation scores, and anxiolysis were assessed preoperatively.Results: Clonidine provided better hemodynamic stability, while Midazolam showed superior anxiolysis. Statistical analysis revealed significant differences (p<0.05) in sedation scores and heart rate changes.Conclusion: Both drugs are effective, but the choice depends on the desired preoperative effect.