AbstractContext: Emergence agitation is a post anesthetic phenomenon commonly associated with ENT surgeries. We studied the effects of maintenance infusion of Dexmedetomidine on prevention of Emergence agitation in adult patients undergoing FESS. Aims: To see the effects of intraoperative dexmedetomidine infusion on incidence of emergence agitation and recovery characteristics in terms of cough, pain and nausea vomiting scores. Settings and Design: A prospective, randomized, controlled, double blinded comparative study done at our institute. Methods and Material: One hundred patients undergoing FESS surgery were randomized into two groups. Group D (n=50) received dexmedetomidine infusion at a rate of 0.5 μg kg−1 hr−1 from induction of anesthesia until extubation, while group C (n=50) received volume-matched normal saline infusion. The incidence of agitation and recovery characteristics in terms of Cough score, Nausea vomiting score and Pain scores were evaluated in both groups. Statistical analysis used: Parametric data were analyzed using oneway ANOVA and the Student’s paired t-test where appropriate. Non parametric data were analyzed using Chi-square test. A value of p < 0.05 was considered statistically signicant. Results: The incidence of Emergence Agitation (Ricker sedation agitation score ≥ 5) was higher in group C compared to group D (p <0.001). Recovery characteristics in terms of Cough score (p=0.118) and Nausea vomiting score (p=0.589) were similar in both groups, while Pain score was higher in Group C compared to Group D (p<0.001). Increase in Heart rate and MAP at emergence was more in Group C compared to Group D. Conclusions: Dexmedetomidine as an adjuvant to general anesthesia for FESS is an excellent drug to reduce Emergence agitation, provide better postoperative pain relief and also maintains stable hemodynamics at emergence.