Background- airway management both in operation theatre and during emergencies remains challenge because of cardiovascular stress response & inflammatory mediators during procedure exhilarating the stress response itself leading to catastrophic events. This study is aimed to evaluate comparative efficacy of dexmedetomidine over fentanyl because of it have not only as sympatholytic also as anti-inflammatory properties. Study was orchestrated at tertiary care centre in western India after approval of institutional scientific & ethical committee. Methodology Study group include 50 patients of either sex aged between 18 to 55 years who were admitted for major surgical procedure and given consent for inclusion. Study group divided in two group for record & statistical analysis of parameters like heartrate, mean arterial pressure at various interval during surgery to ascertain the superiority of dexmedetomidine vs fentanyl in stabilizing cardiovascular stress response.