Introduction: hemodynamic changes during tracheal intubation it is more challenging in head injury patients . Dexmedetomidine is a selective α2 adrenoreceptor agonist used as a sedative and adjuvant with local anesthetic. We hypothesized that adding dexmedetomidine to lignocaine before intubation have positive outcome on hemodynamic changes. Aim and objective: To assess the effect of Intratracheal Dexmedetomidine with lignocaine on hemodynamic changes during intubation in head injury patient .Methodology: Sixty patients admitted in ICU with head injury and need intubation randomly divided into two groups 30 subjects in each group, namely, Group 1 and Group 2. Group 1 received dexmedetomidine 0.5 ml with 4% lignocaine 0.5 ml whereas Group 2 receive normal saline before endotracheal intubation, respectively. The outcomes were the incidence hemodynamic fluctuations during intubation and after intubation .Results: The incidence and severity of hemodynamic fluctuation in Group 1 than in the group 2, during intubation and post intubation is significantly lower . Moreover, compared with Group 2, Group 1 exhibited more stable haemodynamics during intubation as well as post intubation .Conclusion: The combined use of dexmedetomidine and lignocaine intratracheally before intubation significantly reduced the incidence and severity of haemodynamic fluctuations during and after intubation.