This study aimed to compare the efficacy of Midazolam and Dexmedetomidine as premedication agents in pediatric patients administered via the intranasal route. 100 children in ASA physical status I and II, aged 2-8 years, planned for surgery under general anesthesia, were randomly assigned to Group D, which received 1 mcg/kg of Intranasal dexmedetomidine, or Group M, which received 0.2 mcg/kg of Intranasal midazolam for premedication. The patients’ sedation status, separation anxiety, and mask acceptance were evaluated using UMSS, PSAS, and MAS, respectively, along with hemodynamic parameters and side effects. The mean sedation score was higher in Group D than Group M, and the mean parental separation anxiety score and mean mask acceptance score were also higher in Group D than Group M. All hemodynamic parameters were comparable and stable in both groups. In conclusion, intranasal dexmedetomidine was found to provide better sedation, relieve preoperative anxiety, make parental separation easier, and promote better mask acceptance, without any significant side effects.