AbstractContext: Dexmedetomidine a wonderful drug with vital organ protective properties. When combined with other intravenous anaesthetic agents useful in surgical procedure without intubation. Less research work was done on this subject.Objectives: The aim of this study was to compare the effects of dexmedetomidine +propofol with dexmedetomidine+Ketamine combinations for sedation and anesthesia in patients undergoing hysteroscopy and procedures regarding hemodynamic changes, drug requirements and the recovery criteria and postoperative complications. Patient and Methods: Sixty patients aged between 20 50 years, ASA I& II scheduled for hysteroscopy were enrolled in this study. Patients were randomly allocated into two equal groups: dexmedetomidine+propofol (DP) group and dexmedetomidine+ Ketamine (DK) group. Every patient received a loading dose of intravenous (IV) dexmedetomidine 1g/kg over 10 min and Propofol 1mg/kg (DP) or ketamine1mg/kg (DK) group and then maintained by a 0.5 g/kg/h of dexmedetomidine. Mean arterial pressures (MAP) and heart rates(HR),drug consumption,recovery time visual analog scale (VAS ) and postoperative complications were recorded. Results: The intra and post procedural HR and MAP showed statistically significant differences between the both groups throughout the procedure with lower values in DP group (p < 0.01). After procedure recovery time was significantly shorter in DK group (12.2 ± 8.2 min) compared with (15.7±9.6 min) DP group (p = 0.012). VAS was comparable in the two groups. Drug consumption similar in both the groups. Conclusion Dexmedetomidine +propofol combination as total intravenous anaesthesia showed better intra-and postprocedural hemodynamic stability with fewer complications.