Background and Objectives: Haemodynamic responses to direct laryngoscopy and tracheal intubation are noxious stimulus that should be attenuated by appropriate premedication, smooth induction, and rapid intubation. This study evaluates and compares the clinical efficacy of intravenous premedication with Butorphanol or Clonidine for attenuation of haemodynamic stress response to airway instrumentation, sedative, anxiolytic,analgesic effect and to assess the adverse events associated with these drugs.Methods: In thisdouble blind prospective randomized study, 60 patients of ASA I & II patients of either sex, aged 16-60 years, scheduled for various elective surgeries under general anaesthesia were included. They were randomly divided into 2 groups of 30 each, where group B received intravenous Butorphanol 40µg/kg and group C received intravenousClonidine of 3µg/kg 15minutes before surgery. After 3min of pre-oxygenation with 100% oxygen, patients were induced with Inj-Thiopentone 5-7mg/kg followed by Inj-suxamethonium 1.5mg/kg for intubation. After a min, intubation was done within 15 seconds and anaesthesia was maintained with 33%Oxygen+ 67%Nitrous Oxide + 0.8-1% Isoflurane. Further Inj. Vecuronium 0.05mg/kg was administered as and when required till the end of surgery. HR, SBP, DBPand MAPwere recorded at baseline,after premedication and 15 mins later to its administration, after induction & post intubation at 0, 3, 5, 10, 15min and for every 15min till the end of surgery. Sedation scoring, anxiety scoring and VAPS scoring were also compared. Statistical analysis was done using Student’s t-test and Chi-Square test with p-value <0.05 was regarded as significant.Results: Attenuation of haemodynamic response to laryngoscopy and intubation was statistically significant in Clonidine group with P value of <0.05 compared to Butorphanol group. Sedation level was higher in Butorphanol group as compared to Clonidine group. Both the drugs were equally good in terms of anxiolytic and analgesic effect. None of the pre-medicated patients had any significant post-operative side-effects.Conclusion: Intravenous premedication with Clonidine 3μg/kg was superior to Butorphanol 40μg/kgin attenuation of haemodynamic stress response to laryngoscopy and intubation with good pre-operative sedation,anxiolysis and analgesia without any significant side-effects.