Background: controlled hypotension is performed in order to reduce blood loss and the need for transfusion during the surgery and to improve visibility of the surgical site by decreasing the arterial pressure until hypotension is reached. Aim of the Work: to compare magnesium sulphate and nitroglycerin with propranolol during middle ear surgery in terms of regarding their efficiency in inducing deliberate hypotension and providing a better surgical field exposure during middle ear surgery. It also compared the influence of their use of postoperative pain and recovery time. Patients and Methods: forty adult patients undergoing middle ear surgery were included. Patients were randomly divided into two equal groups. Patients were assigned to receive magnesium sulphate (M group) and nitroglycerin with propranolol (N group) from the period of Jan 2018 to August 2018. ASA physical status I, age group ranged from 18 to 60. Results: the current study shows the ability of magnesium sulphate and nitroglycerin with propranolol to induce deliberate hypotension in patients undergoing middle ear surgery. Mean arterial pressure was successfully reduced to the target values in both groups. All drugs were equally successful to produce satisfactory surgical field. Conclusion: this study included forty adult patients age ranged 18 to 60 undergoing middle ear surgery was included. Patients were randomly divided into two equal groups. Patients were received magnesium sulphate (M group), or nitroglycerin and propranolol (N group).