Ｏｂｊｅｃｔｉｖｅ　To investigate the influence of dexmedetomidine on hemodynamics peri-anesthesia in elderly patients undergoing intracranial aneurysm clipping in perioperative period.　Methods　A total of sixty patients undergoing intracranial aneurysm clipping were randomly divided into the dexmedetomidine group (group D) and control group (group C) with 30 cases in each group using random number table. Patients in group D was administrated with Dex continuous infusion (0.5 μg·kg-1·h-1) and patients in group C was infused equal dose of physiological saline until skin closure. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, cardiac output (CO) and cardiac index (CI) were observed and compared between the two groups, at patients entering the operation room (T0), at intubation (T1), 3 min after intubation (T2), 5 min after intubation (T3), at the time of completing tumor separation (T4), at the time of clipping (T5), 30 min after clipping (T6), at extubation (T7), and recovery period (T8). Meanwhile, the recovery situation as well as the incidence of adverse events during recovery period was observed and recorded.　Results　The SBP recordings at T1-T6, DBP at T1-T4 and T6, heart rate at T1-T6, CO at T1-T4 as well as CI at T1-T3 and T6 of group D were statistically lower than the values at same time points in group C(P<0.05). The duration from drug withdrawal to spontaneous breathing recovery and the duration from drug withdrawal to extubation of group D were significantly shorter than the durations in the group C (P<0.05). The respiratory rate in group D was significantly lower than the rate in group C (P<0.05). The Steward score of group D was significantly higher than the score in the group C(P<0.05). The incidence of delirium in group D was significantly lower than the incidence in group C (P<0.05). Moreover, there was no significant difference in the incidence of other adverse events between two groups(P>0.05).　Conclusions　Dex play a positive role in stabilizing elderly patients′ hemodynamics and have the potential clinical application values in promoting patients′ resuscitation and safety in elderly patients undergoing intracranial aneurysm clipping.