Background: Sedation is a necessity for MRI (Magnetic Resonance Imaging) procedures in children for alleviating anxiety and to avoid movements during the procedure. Dexmedetomidine a selective alpha-2 adrenoreceptor agonist is very useful for such procedures. Aims and Objectives: To analyze and compare the sedative, hemodynamic and respiratory effect of Intravenous (IV) dexmedetomidine with IV dexmedetomidine and midazolam combination in children undergoing magnetic resonance imaging (MRI) examination. Material and Methods: Total of 60 patients were studied, 30 in each group, group D and group DM. Group D received inj. Dexmedetomidine 2mcg/kg, Group DM received dexmedetomidine 2mcg/kg and inj. Midazolam 0.03 mg/kg intravenously. The level of sedation was assessed by the Ramsay sedation scale and quality of MRI was assessed using the 3 point scale. During the procedure, respiratory rate, heart rate, oxygen saturation and blood pressure were continuously monitored and recorded using MRI compatible monitors. The data were analysed using SPSS version 24.0. Results: There was significant difference in onset of sedation; the mean values ranged 6.3±2.28 minutes (mins) and 3.23±3.02 minutes for D and DM group respectively (p < 0.05). There was significant difference in the Level of sedation; the mean values ranged 4.57±0.57 and 5.27±0.52 for D and DM group (p < 0.05). There was no significant difference in blood pressure values at various time periods between the two groups. The quality of MRI is better in Group DM than group D. There was no significant difference in heart rate, respiratory rate, oxygen saturation values at various time periods between the two groups. 4 patients in Group D received supplementation, whereas none in group DM received supplementation. Conclusion: Addition of midazolam to dexmedetomidine for sedation helped in decreasing the onset of sedation and also offered a better quality of MRI study without any haemodynamic or respiratory disturbances.