Background: The present study was conducted for comparatively evaluating between Midazolam, Ketamine and combination of both as premedication in pediatric surgeries. Materials & methods: A total of 50 children were enrolled. Only children less than 12 years and more than 2 years of age were included. Completedemographic and clinical details of all the subjects was recorded. Inclusion criteria for the present study included children undergoing orthopedic, pediatric, ophthalmic or plastic surgery lasting for 40 minutes to 150 minutes. Thorough pre-treatment examination of all the patients was carried out. Random division of all the patients was done into two study groups as follows:Group 1: 25 pediatric patients subjected to Intranasal Midazolam (0.2 mg/kg), and Group 2: 25 pediatric patients subjected to Intranasal Midazolam (0.15 mg/kg) with Ketamine [1 mg/kg]. Findings were recorded in Microsoft excel sheet followed by statistical analysis using SPSS software. Results: Among group 1, there were 13 boys and 12 girls while among group 2, there were 15 boys and 10 girls. Significant results were obtained while comparing the level of sedation at 20 minutes. While comparing the emotional reaction at 20 minutes in between the two study groups, significant results were obtained. Mean onset time of sedation among patients of group 1 and group 2 was 10.95 minutes and 10.08 minutes respectively. Mean postoperative recovery time was 22.12 minutes and 29.23 minutes respectively. Postoperative analgesic requirement was seen in 64 percent of the patients of group 1 while it was seen in 16 percent of the patients of group 2. Conclusion: Children can be sedated quickly and predictably with intranasal premedication. The midazolam plus ketamine group considerably provides superior analgesia, sedation, and comfort.