: Introduction: Bronchoscopy is one of the essential methods for diagnosing lung diseases that is associated with many different uncomfortable complications for patients. The aim of this study was to compare fiberoptic bronchoscopy with midazolam-based anesthesia and lidocaine-based anesthesia. Materials and Methods: The present study is a double-blind clinical trial study that was performed on patients who underwent bronchoscopy from 2017to 2018. Midazolam-based anesthesia was compared with lidocaine-based anesthesia, and then the data were analyzed using SPSS software version 21. Results: 140 patients were studied (mean age total 61.4 years) and among them 52.14% were male and 47.86% were female. Half of the Individuals received midazolam and half of them received lidocaine. The use of lidocaine has been much more satisfactory for physicians and patients, in comparison with midazolam. Complications of bronchoscopy (nausea, decreased arterial blood oxygen saturation, sore throat, cough, and need for intubation) and the duration of bronchoscopy were lower in those who received lidocaine than in those who received midazolam. Conclusion: The use of lidocaine in bronchoscopy reduced complications such as nausea, sore throat, cough, intubation, duration of bronchoscopy, and decreased arterial blood oxygen saturation, and was associated with increased patient and physician satisfaction. Lidocaine can be an appropriate alternative medicine for use in bronchoscopy