We evaluated the curative effect of dexmedetomidine on paroxysmal sympathetic hyperactivity (PSH) in a retrospective study of 72 PSH patients after neurosurgery. Our results showed that dexmedetomidine was superior to propofol for treatment of PSH with respect to: average time needed to reduce paroxysmal hypertension (PH) to 0.05). These data suggest dexmedetomidine effectively controls an acute attack of PSH, but it does not improve the long-term prognosis of patients compared with propofol.