Background and aims: Laryngoscopy and tracheal intubation incite remarkable sympathetic activity and are associated with transient but significant hemodynamic pressor response. Dexmedetomidine is a highly selective alpha 2 agonist which attenuates the pressor response. Our study comparatively evaluated the efficacy of nebulized and intravenous dexmedetomidine on the attenuation of hemodynamic response to laryngoscopy. Methods: In this prospective, randomized, double-blinded study, sixty adults were divided into two groups of thirty each. Group A received nebulized dexmedetomidine 1 mcg/kg and Group B received Inj. dexmedetomidine 1 mcg/kg IV infusion over 10 minutes, 30 min before intubation. The primary objective was to compare the mean arterial pressure (MAP) between the two groups following laryngoscopy and tracheal intubation for up to 10 minutes. The secondary objectives were to compare preoperative Ramsay sedation scores, mean dose of propofol required for induction of anesthesia, changes in heart rate (HR), and any side effects in both groups. RStudio Desktop Version 2023.03.0+386 was used for statistical analysis. Results: In both groups, there were no changes seen in the MAP (p > 0.05) or HR (p > 0.05) after laryngoscopy and intubation. Preoperative sedation scores were comparable in both groups. Statistically, no significant difference was noted. The mean propofol consumption was found to be higher in Group A compared to Group B (p < 0.05). Conclusion: We conclude that the MAP and HR response to laryngoscopy and tracheal intubation were equally attenuated in both nebulized and intravenous dexmedetomidine groups.