Background and Objectives: Premedication in paediatric patients undergoing surgery is very much essential to lessen the trauma of separation from parents, to allay apprehension regarding anaesthesia and surgery, to co-operate for venipuncture, mask acceptance and to facilitate induction of general anaesthesia. Midazolam is an ideal premedicant with many desirable properties such as sedation, anxiolysis, minimal cardiovascular and respiratory effects, anterograde amnesia. Hence the present study was undertaken to compare between intranasal midazolam and oral midazolam with respect to onset of sedation, effectiveness and safety. Methodology: The study population consisted of 100 ASA grade I and II patients aged between 2-8 years posted for various elective surgeries at NMCH, Patna. The study population was randomly divided into 2 groups of 50 patients each. Conclusion: Thus from the above study, we conclude that Onset of sedation was significantly faster with intranasal administration compared with oral route. Midazolam administration by either route was equally. effective and no statistical differences were seen between them. All vital signs were stable throughout the procedure in both groups and no significant differences were seen.