Introduction: Numerous methods have been used to examine how effectively dexmedetomidine(Reel B & Maani CV, 2023) reduces the pressor response to laryngoscopy and intubation. The nasal passages may get irritated when dexmedetomidine is administered intranasally. Nebulized dexmedetomidine might be a superior option as drug deposition throughout the nasal, buccal, and respiratory mucosa occurs uniformly after nebulization(Shrivastava et al., 2022). Preoperative anxiety and stress responses are responsible for the activation of the sympathetic, parasympathetic, and endocrine systems(Geeta Singariya et al., 2022). On the other hand, during laryngoscopy, the intravenous method has shown quicker onset and potent inhibitory effects on the pressor response. The effect of premedication with nebulized (Neb) as compared to intravenous (IV) dexmedetomidine on the pressor response attenuation to laryngoscopy and endotracheal intubation was evaluated in this research. Evaluating its effects on the use of intraoperative analgesics and postoperative sore throat was a secondary objective. Methodology: On the approval of the Institutional Ethical Committee, 60 ASA grade I and II patients in the age group of 18-65 years who were planned for elective surgery under general anesthesia were enrolled in the study(Shrivastava et al., 2022). 60 Patients were divided into two groups of 30 in each; Group A The IV-Dex was given 30 minutes before to the induction of anaesthesia (1 mcg/kg body weight in 100 ml 0.9% normal saline, administered over 10 mins). Group B: Neb-Dex (1 mcg/kg body weight diluted over 10 minutes with 4 cc of normal saline) 30 minutes prior to the anaesthesia induction. the mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), systolic blood pressure (SBP) and oxygen saturation of arterial blood (SpO2) were monitored. Postoperative sore throat and use of intraoperative analgesics were also evaluated. Results: Patients receiving IV dexmedetomidine showed better attenuation of the pressor response as compared to patients with nebulized dexmedetomidine. However, The IV dexmedetomidine group exhibited a greater incidence of bradycardia and hypotension. There were no postoperative sore throat complaints from patients who were nebulized with dexmedetomidine. Analgesic and propofol use were lower in both groups. Conclusion: Despite both nebulized and intravenous dexmedetomidine attenuating the pressor response to laryngoscopy and intubation, intravenous dexmedetomidine reduced the pressor response more effectively. Incidence of hypotension & bradycardia was observed more in patients receiving IV dexmedetomidine(Shrivastava et al., 2022) as compared to those nebulized with dexmedetomidine. The postoperative sore throat was lower in the nebulized group as compared to the intravenous group. Thus, we conclude that dexmedetomidine nebulization at a dose of 1µg/kg given 30 minutes before induction of general anesthesia is effective in attenuating the pressor response to laryngoscopy & intubation without any adverse effects like bradycardia & hypotension along with the lower incidence of postoperative sore throat.