Background: Midazolam effectively maintains hemodynamic and respiratory variables even in poor risk patients. Its onset of action is quicker, and there is less individual variation in response than after the administration of diazepam. We evaluated the hemodynamic effects of ketamine –midazolam and ketamine– diazepam combination in patients undergoing elective surgeries. Methods: The present study was carried out in 100 patients of either sex , between the age group 18–35 years belonging to ASA class I &II undergoing elective surgeries under general anesthesia. Patients were divided into 2 groups of 50 each according to combination of induction agent used. Group I included patients receiving ketamine (0.75 mg/kg) + midazolam (0.15mg/kg) and Group II receiving ketamine (0.75 mg/kg) + diazepam (0.15 mg/kg). Results : Group I showed a significant increase in heart rate at the time of intubation p<0.01, which persisted up to 15 minutes of anesthesia. There was a significant increase in heart rate, systolic diastolic and mean arterial in group II (p value<0.001). Conclusion: Midazolam a water soluble benzodiazepine is more effective than diazepam to attenuate the cardio–stimulatory response and post–operative emergence phenomena associated with ketamine.