Background: During the induction of general anesthesia, fentanyl is a widely used analgesic. Fentanyl induced cough (FIC) might be a serious complication .Tramadol is a centrally acting codeine analogue, which has an antitussive effect as well as an NMDA antagonist effect. Our study aims to evaluate result of the pre-operative administration of 2 different doses of tramadol I.V. on Incidence and severity of fentanyl-induced cough were compared to placebo. Methodology: In a prospective, double-blind randomized sample, 150 ASA (I - II) patients between the ages of 20 & 60 who were scheduled for elective surgeries under general anaesthesia were assigned to one of three groups: End Result: There was a substantial reduction in the number of cases of FIC in tramadol treated groups, compared to the placebo group being (8(16%)) for group T1 and (7(14%)) for group T 2 compared to the group S (18(36%)) with p value (0.019) & (0.022) respectively, When group T1 was compared to group T2, there was no statistically significant difference with p value of ( 0.736 ). In terms of the quality of the FIC; 11 from 18 in group S, 6 from 8 in group T1 and 4 from 7 in group T2 exhibited a mild type, 6 from 18 in group S, 2 from 8 in group T1 and 3 from 7 in group T2 exhibited mild type, and 1 from 18 in group S showed severe form without the presence of patients in T1 and T2 groups exhibited severe type. There was no substantial difference between the 3 group in terms of the postoperative nausea and vomiting. Conclusion: The Tramadol with different doses; 1mg / kg and 2mg / kg IV 15 minutes. Before anesthesia induction can reduce the incidence & severity of fentanyl-induced cough compared to placebo, but there is no significant distinction between the 2 doses concerning to the incidence & severity of cough.