Background: Dexmedetomidine is a valuable sedative choice in the ICU setting, demonstrating benefits such as reducing delirium incidence and duration, delaying delirium onset, and potentially decreasing the need for other medications. The study aimed to provide valuable insights into the potential effects of dexmedetomidine dosing on sedation quality and clinical outcomes in critically ill patients receiving mechanical ventilation in the ICU. Materials and Methods: The primary aim was to compare the percentage of time spent within the target sedation range (RASS score of -2 to 0) between standard-dose and high-dose dexmedetomidine groups. Additionally, the study examined secondary efficacy outcomes including lengths of hospital and ICU stay, duration of mechanical ventilation, and the requirement for adjunctive sedation. The safety outcomes encompassed monitoring for bradycardia, hypotension, and the use of vasopressor agents. Results: Patients of the high dose didn’t show any significant difference in terms of occurrence of adverse events, hospital stay, and ICU stay. Conclusion: This study indicates that high doses of dexmedetomidine in the ICU did not show superior sedation efficacy and were associated with a higher need for additional sedation and prolonged mechanical ventilation.