Background: Laryngeal mask Airway(LMA) is commonly used as an alternative toendotracheal intubation for short surgical cases as it allows both spontaneous as well as positive pressure ventilation1. Propofol being well known inducing agent, is popular for its smooth induction properties. Previous studies have shown fentanyl and dexmedetomidine can be used as an adjuvant to propofol for general anaesthesia.In our study we compared the effect of dexmedetomidine and fentanyl administered before propofol, on laryngeal mask airway insertion condition, hemodynamics and apnoea time in patients posted for chronic subdural hemorrhage evacuation under general anaesthesia. Method& materials: This prospective randomized double blind study was carried out on 180 patients,after taking clearance from institutional ethics committee.Patients were divided into two equal groups. GroupFp ( Fentanyl- Propofol group N= 90) and Group Dp ( Dexmedetomidine - Propofol N= 90). Group Fp and Group Dp: Patients were given inj. fentanyl 1 mcg/kg and inj dexmedetomidine diluted in 10 ml normal saline iv over 10 minutes respectively. Thirty second after study drugs, patients were induced with inj. propofol 2mg/kg iv and PLMA was inserted after 90 seconds of inj propofol. Ease of PLMA insertion was assessed, according to Muzi scoring system such as jaw mobility, coughing, gagging or any movements were noted. In each category score < 2 was considered optimum for PLMA insertion. HR,SBP, DBP, MAP,SPO2 and RR were noted at baseline(BL), after administration of study drug(AASD), before PLMA insertion(BLI), after PLMA insertion(ALI),1,3,5,10 and 15 minutes after PLMAinsertion.Apnoea time is the time, from last spontaneous breath after propofol administration to first spontaneous breath of the patients was noted.In both the groups, SpO2 was maintained throughout the study to 100%. Result: In the Dp group, all patients(100%), had jaw mobility which was optimal for PLMA insertion while in the Fp group 96.66% patients had acceptable score for jaw mobility. In Dp group HR, SBP, DBP and MAP was found significantly low throughout the study period following LMA insertion, while in GroupFp there was rise in the above parameters noted immediately after LMA insertion. Incidence of apnoea was significantly higher (P < 0.0001) in group Fp (18/20%) than Group Dp (3/3.33%).Mean duration of apnoea in Group Fp (284.5 ± 11.19 sec) was significantly higher than Group Dp (217.17 ± 16.48 sec). Conclusion: The addition of dexmedetomidine to propofol provides superior insertion condition and good jaw mobility for ease of insertion of PLMA in the first attempt as compared to fentanyl. Dexmedetomidine - propofol also provides better hemodynamic responses with minimal or no intraoperative and postoperative complication as compared to fentanyl-propofol.