Background: A prospective, randomized, double–blind study was designed to evaluate the effects of intranasally administered dexmedetomidine vs. intranasal midazolam as a premedication in children undergoing minor surgical procedures.   Methods: 100 children of 2–8 years of age with ASA–1 physical status posted for minor surgical procedures were divided in to two groups. Group D received intranasal dexmeditomedine 1 μg/kg and group M received intranasal midazolam0.2 mg/kg. The patient’s vital data and sedation status, behavioural and child parent separation scores were recorded every 10 minutes for 30 minute before induction of anaesthesia. Post anaesthesia recovery conditions were also assessed by paws score.   Results: The sedation scores before induction were significantly lower in group D (2.9±0.36) than group M (4.84± 0.37).The behavioural scores also significantly lower in group D than group M (1.04 ± 0.28 vs. 2.54± 0.50).Compared with the children in group M, those in group D were significantly more sedated when they were separated from their parents (2.1 ±0.30vs.1.00 ± 0.00, respectively).18 children (36%) in group M, showed signs of nasal irritation and none of these signs was seen in the children in group D. The PAWS score of group D is 1.04±0.19 which is lower than group M 1.98±0.25 and it is statistically significant. There were no incidences of bradycardia, hypotension, in either of the groups during study observation.   Conclusions: Intranasal dexmedetomidine is more effective than intranasal midazolam as premedicant in view of lower sedation score easier child parent separation and better postoperative recovery without any adverse side effects.