Objective: To explore the effect of preoperative use of dexmedetomidine hydrochloride nasal spray on anesthesia induction and recovery state of preschool children. Methods: 60 preschool children undergoing elective surgery under general anesthesia were divided into group M and group D by different intervention methods, with 30 cases in each group. Children were given intranasal dexmedetomidine hydrochloride nasal spray and 0.9% normal saline at 30 minutes before entering the operating room respectively. The perioperative anxiety status [modified Yale preoperative anxiety scale (m-YPAS) score], anesthesia induction compliance [induction compliance checklist (ICC) score], recovery quality [recovery time, residence time in post-anesthesia care unit (PACU), emergence agitation score] and incidence of adverse reactions were compared between two groups. Results: The m-YPAS scores at the time of separation from parents (T1) and at the time of anesthesia induction (T2), ICC score during anesthesia induction and emergence agitation score in group M were lower than those in group D (P<0.05). The recovery time and PACU stay time were shorter in group M than in group D (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion: Preoperative intranasal administration of dexmedetomidine hydrochloride nasal spray in preschool children can relieve anxiety, enhance anesthesia induction compliance, and improve treatment during recovery.