Background: Managing the surgical population of children is a challenging task. For children to finish the process, the operating room must be a stress-free place. This study compared intranasal Dexmedetomidine and Oral Midazolam in Paediatric dental patients as premedication. Materials &Methods: 80 children age ranged 4-9 years of either gender with American Society of Anesthesiologists (ASA) grade Iwere divided into 2 groups of 40 each. Group I patients were administered intranasally with 2 μg/kg dexmedetomidine hydrochloride injection half an hour before the induction of anaesthesia. Group II patients were administered with oral 0.5 mg/kg midazolam half an hour before the induction of anaesthesia. Parameters such as heart rate, oxygen saturation (SpO2) and respiratory rate in both groups were monitored. The HR, RR, and SpO2 was recorded at 10 min (T1), 20 min (T2), and 30 min (T3) after administration. Parental separation anxiety scale (PSAS) and mask acceptance scale (MAS) was recorded. Results: There age group 4-6 years comprised of 21 patients in group I and 22 in group II and 7-9 years had 19 in group I and 18 in group II.RR (breaths/min) at baseline, 10 minutes, 20 minutes and 30 minutes in group I and group II was 22.8 and 22.6, 24.1 and 23.4, 20.7 and 20.9 and 20.2 and 20.5 respectively. The mean heart rate (beats/min) at baseline was 113.4 and 104.2, at 10 min was 94.4 and 97.4, at 20 min was 91.0 and 92.4 and 30 minwas 88.2 and 91.6 respectively. The mean SpO2 (%) at baseline was 98.9 and 99.2, at 10 min was 98.2 and 97.1, at 20 min was 98.5 and 98.4 and at 30 min was 97.2 and 96.6 respectively. There was non- significant difference (P> 0.05). Successful parental separation was observed in 95% in group I and 92% in group II. Emergence delirium was present in 18% in group II. Mask acceptance score was satisfactory in 94% in group I and II each. A non- significant difference was observed (P> 0.05). Conclusion: In Pediatric dentistry patients, both premedication agents were found to be equally efficacious when administered under general anesthesia.