Introduction: Pneumoperitoneum from Carbon di oxide insufflation will result in increase plasma levels of catecholamines and vasopressin that leads to hemodynamic disturbances. These effects are exaggerated by the steep trendelenburg position. This study was designed to evaluate the effect of Dexmedetomidine and fentanyl on hemodynamics in laparoscopic gynaeconcolgy surgeries which requires steep trendelenburg position. Methods: After obtaining Ethical committee clearance and patients consent, prospective randomised comparative study was done on 60 ASA I and II patients who were randomly assigned to receive either dexmedetomidine or fentanyl infusion. Patients with ASA III & IV, on β blockers were excluded. Intraoperative hemodynamics, recovery and emergence was assessed. Students ‘t’ test was used Results: The study included 60 patients undergoing laparoscopic gynaecology oncology surgeries requiring steep trendelenburg positions. Dexmedetomidine group of patients had better intra operative hemodynamics throughout and postoperative recovery when compared with Fentanyl group of patients. Conclusion: Using Dexmedetomidine infusion in patients will have stable hemodynamics and postoperative recovery also smooth as compared to fentanyl