ABSTRACT Background: Numerous pharmacological agents effectively lower the systemic blood pressure for hypotensive anaesthesia techniques. The present study was conducted to assess dexmedetomidine infusion during middle ear surgery under general anaesthesia. Materials & Methods: 50 adults scheduled for elective middle ear surgery of both genders were divided into two groups of 25 each. Group I received infusion of dexmedetomidine 0.5 μg/kg/h and group II received placebo infusion of normal saline during middle ear surgery. Intra-operatively, the heart rate, arterial blood pressure, ECG, EtCO2 and peripheral pulse oximetry (SpO2) were monitored and recorded at 5 min intervals till end of surgery. The mean surgery time and isoflurane requirement was recorded. Results: Group I had 12 males and 13 females and group II had 11 males and 14 females.ASA grade I was seen in 20 in group I and 19 in group II and II in 5 in group I and 6 in group II. The mean heart rate at baseline was 94.5 in group I and 92.1 in group II, after induction was 74.2 in group I and 70.6 in group II, after intubation was 76.4 in group I and 75.2 in group II and after extubation was 82.6 in group I and 96.4 in group II. Percentage of isoflurane requirement was 0.9 in group I and 1.5 in group II and the mean surgery time was 95.4 minutes in group I and 104.2 minutes in group II. The difference was significant (P< 0.05). Conclusion: Dexmedetomidine infusion provided sufficient oligaemic surgical field for better visualisation under operating microscope for middle ear surgery.