Background: Many anesthetics and sedative drugs can be used for sedation in upper gastrointestinal endoscopy (UGE) in pediatrics, however recovery profile and safety are priorities. Objectives: To compare the recovery profile from sedation and complications of sevoflurane inhalation with intravenous ketamine, midazolam and propofol combination for sedation in pediatrics scheduled for elective UGE. Patients and methods: This prospective randomized comparative clinical study included 74 pediatric patients aged one to four years old, ASA I or II who were scheduled for an elective UGE. They were randomly allocated into two groups; Group S (n=37): received inhalational 7% sevoflurane in oxygen via face mask for induction of sedation and 4% for maintenance via nasal cannula and Group KMP (n=37): received intravenous ketamine (1mg/kg), midazolam (0.05mg/kg) and propofol (1mg/kg) combination as induction doses and incremental doses of propofol alone (0.5 mg/kg) IV for maintenance of sedation as needed. The recovery time from sedation and complications were compared. Results: The duration of recovery was significantly shorter in S Group than in (KMP) group (11.17±1.95 minutes versus17.09±2.50, P<0.001). Regarding complications, there were no significant differences between the two groups, but the incidence of oxygen desaturation was higher in the group (KMP) (13.5%) than in group (S).(5.4 %), however it was statistically non-significant ( P 0.233) Conclusion: Sedation technique using inhalation of sevoflurane provides faster recovery from sedation and more safety than intravenous ketamine, midazolam, and propofol combination and can be utilized as a safe alternative technique for sedation in children undergoing elective UGE.