Background and aim: Direct laryngoscopy, tracheal intubation, and extubation contribute to augmentation in heart rate and blood pressure. This can precipitate serious complications in patients with coronary artery disease, intracranial neuropathology, or reactive airways. Attenuation of hemodynamic stress response to laryngoscopy, intubation, and extubation is essential for better anesthetic outcome. The aim of this study was to evaluate the effect of oral pregabalin as premedication in attenuation of hemodynamic stress response to laryngoscopy, intubation, and extubation. Materials and methods: This prospective randomized double-blinded placebo controlled study was conducted with 60 patients of American Society of Anesthesiologists (ASA) physical status class I/II, undergoing elective laparoscopic cholecystectomy. Patients were allocated randomly into two groups receiving either oral placebo or oral pregabalin 150 mg, 120 minutes before induction of anesthesia. Hemodynamic parameters such as heart rate, systolic, diastolic, and mean blood pressures were compared at various time points. Results: Pregabalin showed a significant attenuation of hemodynamic stress response to laryngoscopy, tracheal intubation, and extubation compared with that of placebo. The pregabalin premedicated patients remained hemodynamically stable perioperatively without any significant side effects. Conclusion: Pregabalin is effective in attenuating hemodynamic stress response to laryngoscopy, tracheal intubation, and extubation.