Background and Aims: Laparoscopic cholecystectomy is being preferred surgery for gall bladder diseases under general anesthesia in the present era. This study was designed to compare oral pregabalin versus intravenous dexmedetomidine as premedication in attenuating the hemodynamic responses in laparoscopic cholecystectomy. Material and Method: This prospective randomized double blind study was conducted in 90 patients (ASA) grade I or II, divided into two groups of 45 each. Group P- received oral pregabalin 150 mg 1 hr prior to surgery and intravenous normal saline (0.9%). Group D- received oral placebo tab 1 hr prior to surgery and IV dexmedetomidine 1 µg/kg with normal saline. Demographic data and haemodynamic parameter like heart rate, systolic, diastolic and mean blood pressure along with oxygen saturation and end tidal CO2 were noted. Assessment of pain by visual analogue pain score (VAS) and sedation by Ramsay Sedation Scale (RSS) was done. The time to first rescue analgesic and total dose of analgesics in 24 hrs were noted. Statistical analysis was done using SPSS software (version 17, SPSS, Chicago, IL). Result: In group P significant haemodynamic response was observed at laryngoscopy, after intubation and during pneumoperitonium while in group D it was significantly attenuated (p<0.05). In group D VAS score was lower and RSS score was more as compare to group P which was statistically significant (p< 0.05). The time for first resque analgesic was earlier in group P (37.5 ± 9.30) than group D (58.06 ± 11.62) (p<0.001). Conclusion: Dexmedetomidine was found to be more effective than pregabalin in maintaining hemodynamic responses along with better postoperative analgesia and more sedation than pregabalin group.