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Objectives: The airway instrumentation of direct laryngoscopy and tracheal intubation is powerful noxious stimuli that should be attenuated by appropriate premedication, smooth induction, and rapid intubation. This study compared the efficacy intravenous dexmedetomidine and oral pregabalin premedication for attenuation of hemodynamic pressor response to laryngoscopy and intubation.Methods: A total of 60 patients of age group 20-50 years scheduled for elective surgeries under general anesthesia with American Society of Anesthesiologists physical Status I and II were divided into two groups each of 30. Group D received intravenous dexmedetomidine 1 mcg/kg over 10 minutes before induction, and Group P received oral pregabalin 150 mg 1 hr before intubation. Parameters observed were heart rate (HR) and mean arterial pressure (MAP) at baseline, after induction, immediately after intubation and then 5, 10, 15, and 30 minutes thereafter.Results: Attenuation of HR in group dexmedetomidine (78.12±10.0/minutes) immediately after intubation was statistically significant than group pregabalin (89.76±10.45/minutes). MAP significantly (p<0.05) decreased after intubation with dexmedetomidine. As compared to oral pregabalin, attenuation of HR and MAP was statistically significant till 30 minutes after intubation with intravenous dexmedetomidine. Conclusion:Intravenous dexmedetomidine 1 µg/kg is more effective than oral pregabalin 150 mg in attenuating hemodynamic response to laryngoscopy and orotracheal intubation.