Background: Endotracheal intubation is the prominent cause of airway mucosal injury which results in postoperative sore throat (POST), with an incidence of 21%–65% if left unresolved, it produces significant agony and annoyance to the patient. Objective: The aim of the present study was to compare the hemodynamic effect of nebulized dexamethasone and nebulized ketamine on postoperative sore throat after thyroid surgeries. Patients and methods: This prospective controlled randomized double-blind study was carried out in Zagazig University Hospitals during the period from January to July 2021, included 72 patients of both gender in the age group 21-50 years, undergoing thyroidectomy under general anesthesia. Results: There was statistically significant increase of the severity and incidence of sore throat in the control groups immediately postoperatively, 2, 6, 12 and 24 hours postoperatively among the studied groups. While, there was significant difference between dexamethasone groups and ketamine group regarding the severity and incidence of sore throat immediatley, 2, and 6 hours (hr) postoperatively. Conclusions: We concluded that nebulized dexamethsone may be considered as a safe alternative to nebulized ketamine for decreasing POST.