Objective To analyze the anesthetic effect of dexmedetomidine in cleft lip and palate repair. Methods A total of 62 children with cleft lip and palate admitted to our hospital from May 2023 to April 2024 were randomly divided into group A and group B, with 31 children in each group. All patients underwent cleft lip and palate repair under general anesthesia with tracheal intubation. At 10 min before operation, group A was given intravenous infusion of pediatric sugar saline (0.2 mg/kg), and group B was given dexmedetomidine in the same way and equal volume. The hemodynamic indexes, pain and sedation scores, and adverse reactions after extubation were compared between the two groups. Results MAP at T2-T4 in group B was lower than that in group A, and HR at T2-T5 was lower than that in control group (P <0.05). The pain score at T4 and T5 in group B was lower than that in group A, and the sedation score was higher than that in group A (P <0.05). The incidence of adverse reactions after extubation in group B was 3.23%, which was lower than 25.81% in group A (P <0.05). Conclusion Dexmedetomidine has a definite application effect in cleft lip and palate repair, which can maintain hemodynamic stability, reduce pain, and has a good sedative effect. Meanwhile, the incidence of adverse reactions after extubation is low, and the application safety is high.