Sevoflurane is a popular inhalational anesthetic agent used for induction and maintenance of anesthesia in pediatric patients. Because of its low blood solubility, it allows rapid induction and emergence from general anesthesia. However, when it is used as sole anesthetic agent, it is associated with a high incidence of emergence agitation (EA) that may be harmful to patients. Objective: Our review Article aimed to discuss Preoperative Oral Dextromethorphan versus Ketamine or Midazolam for Attenuating Sevoflurane Emergence Agitation in Preschool Children Undergoing Adenotonsillectomy. Methods: Relevant citations were extracted from Pubmed, Google scholar, Clinical key, Scopus, Med-line, and Cochrane to discuss Preoperative Oral Dextromethorphan versus Ketamine or Midazolam for Attenuating Sevoflurane Emergence Agitation in Preschool Children Undergoing Adenotonsillectomy Review Article will cover the followings: • Dextromethorphan • Midazolam • Ketamine • Emergence agitation • Effects of sevoflurane versus other general anaesthesia on emergence agitation in children Conclusion: Premedication with ketamine is more effective than midazolam and dextromethorphan in preventing EA during the early emergence period after sevoflurane anaesthesia in children in comparison to placebo treated group in children undergoing adenotonsillectomy without reported side effects including (vomiting, hallucination, respiratory center depression except for nausea occurred and being lower in dextromethorphan group than other groups).