Aims and Objectives: Our aim of the study is to compare dexmedetomidine and esmolol as a hypotensive agent in patients posted for middle ear surgery. Material and Methods: 60 patients (ASA physical status I–II), age group of 18–55 years scheduled for middle ear surgery were recruited for study. 30 patients to group E to have Esmolol whereas remaining patients were named “D” have Dexmedetomidin. Group D (n=30) were pre-loaded with Inj. Dexmedetomidine 1 µg/kg over 10 minutes followed by maintenance with 0.4-0.7 µg/kg/hr. Group E (n=30) received Inj. Esmolol 1 mg/kg pre-loading followed by maintenance with 0.4-0.7 mg/kg/hr as per hemodynamics. patients’ cardio-respiratory parameter were continuously observed and recorded. They were also observed for surgical field, time to eye-opening and requirement of another hypotensive agent. Observation and Results: We have observed stable hemodynamics in group D as compare to group E. We have also observed significant less time for eye opening, less requirement of muscle relaxants and inhalational agent and other hypotensive agent. Conclusion: Dexmedetomidine is better option with good stability of hemodynamics and lesser requirements of inhalational and neuromuscular blocking anaesthetic drugs with better post operative outcome.