Context: Controlled hypotension is required for middle ear surgery to achieve a bloodless operative field which is achieved by dexmedetomidine. Aims: To study and assess the efficacy of dexmedetomidine infusion in lower doses i.e., 0.25 mcg/kg/hr to lower systolic blood pressure below 30% of baseline values, quality of oligaemic surgical field to achieve the targeted SBP in patients undergoing middle ear surgery. Settings and Design: Double blinded Randomised Control Prospective Study. Methods and Material: After obtaining ethical committee permission and patient consent, the study was conducted on 50 patients aged 18 to 60 years belonging to ASA-PS I and II undergoing middle ear surgery, were randomly divided into 2 groups. Group A received dexmedetomidine 0.25 μg/kg/hr as continuous IV infusion. Group B received dexmedetomidine 0.5 μg/kg/hr as continuous IV infusion. Exclusion criteria included cardiovascular disease, hypovolemia, bradycardia, hepatic impairment, pregnancy and lactating mothers, on sedatives and hypnotics, known allergy to dexmedetomidine. Statistical analysis used: Data analyzed- SPSS 22.0 software. Categorical data: frequencies, proportions. Test of significance: Chi-square test. Continuous data: Mean standard deviation. Test of significance: Independent t test. p value: < 0.05- statistically significant. Results: There was insignificant difference in mean HR, mean SBP, mean DBP among both groups. Both groups had excellent surgical field favourable to operating surgeons with similar grading of surgical bleed. Conclusions: Dexmedetomidine at lower doses i.e., 0.25 μg/kg/hr can be used safely to yield blood less surgical field in middle ear surgeries by allowing the hemodynamic variations within the physiological range.