Aims: Cardiovascular response was increase by direct laryngoscopy and endotracheal intubation. The aims of this study the hemodynamic change and compare the best among the two drugs in prevention of cardiovascular response to direct laryngoscopy and Endotracheal intubation. Background: This study also evaluates the efficacy of intravenous Esmolol (1 mg/kg) and intravenous Lidocaine (1.5 mg/kg) in attenuating cardiovascular stress response during direct laryngoscopy and endotracheal intubation in normotensive patients undergoing plan routine surgeries. Materials and Methods: This prospective study was conducted from June 2017 to May 2019 after informed consent was obtained from 120 patients. The study population consisted of ASA physical status I or II, and Mallampatti Score 1 or 2. All patients had enrolled our study are between the age of 20 years and 65 years and are scheduled for various elective surgical procedures. This study was a prospective, randomized, and clinical comparison study in rural tertiary referral health center. The Sample size for the study was 120 generated using a sample size calculator. The study participants were divided into Three Groups. A study patient (Group A) who was received intravenous esmolol 1 mg/kg two minutes before intubation. In Group B, who was received intravenous Lidocaine 1.5 mg/kg, two minutes before intubation and Group C, who received only prescribed premedication and listed in Control Group. All drugs were diluted in 10 milliliters of distilled water. All patients were monitored Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP) with respect to time. All patients were kept unaware of the drug injected to enable double-blinding. Results: Group C had statistically highly significant (p ≤ 0.0001) value of HR, SBP, DBP, and MAP at all time interval after intubation when compared to Group B and Group C had statistically significant (p ≤ 0.05) higher values of hemodynamic variable at all time interval when compared to Group A. Conclusions: Intravenous lidocaine (1.5 mg/kg) and esmolol (1 mg/kg) are effective agents in suppressing the hemodynamic response to laryngoscopy and intubation without any deleterious effect. Esmolol 1 mg/kg appears to be very effective and should be viewed as potential treatment strategy for attenuating hemodynamic changes during induction of anesthesia.