Study Objective: To compare intravenous dexmedetomidine in combination with midazolam and dexmedetomidineas premedication in patients receiving spinal anaesthesia. Design: Prospective randomized controlled double blind study. Methodology: 60 patients belonging to ASA physical status I and II scheduled for surgery under spinal anaesthesia were randomly selected for the study and were randomly divided into two groups of 30 each. Group DM patients received intravenous dexmedetomidine 1 μg/kg in combination with midazolam 0.025 mg/kg (bolus) and group D patients received intravenous dexmedetomidine1 μg/kg (bolus) as premedication before receiving 3 ml (15 mg) of intrathecal hyperbaric bupivacaine (spinal anaesthesia). Hemodynamic changes, to note down the level of sedation, additional analgesic requirements preoperatively, and complication if any were studied. Results: Ramsay sedation score was statistically significant in the dexmedetomidine in combination with midazolam group (DM) for 20 minutes in comparison with Dexmedetomidine (D) group, and there after the sedation scores were similar in both the groups (sedation score of 2-3) without any respiratory depression. The time request for analgesia, hemodynamic parameters and side effects were similar in either of the groups. Conclusion: Intravenous bolus of dexmedetomidine (D) is sufficient to provide adequate sedation with good hemodynamic stability and without respiratory depression in patients who receive spinalanesthesia.