Abstract: Since laryngoscopy and tracheal intubation may result in hemodynamic responses in the form of increasing blood pressure and heart rate and also lead to arrhythmia and myocardial ischemia in the susceptible individuals and these changes can be even harmful for elder people. The present study was conducted to compare Alfentanil and during anesthesia induction and tracheal intubation in the elderly. Forty patients were randomly allocated in two groups in this double blind randomized clinical trial candidates for cataract surgery and received the general anesthesia. Before the anesthesia induction 10 �g kg ¹ Alfentanil and 0.5 �g kg ¹ Remifentanil were injected respectively in the first and second groups within 30 sec. Both groups received similar general anesthesia and 1 �g kg ¹ Alfentanil and 0.1 �g kg ¹ Remifentanil were, respectively infused in the first and second groups during anesthesia. Heart rates, systolic blood pressure, diastolic blood pressure and mean arterial pressure of the patients were regularly measured and recorded in different stages: before anesthesia induction, after drugs injection, after tracheal intubation and after at 2, 4, 6, 8 and 10 min later. The data were analyzed using the discriptive and analytic statistics in SPSS statistic software in the form of statistic-T test and chi square. After injection of the initial dose of the narcotics, immediately a remarkable decline was found in hemodynamic variables. But decreaser diastolic blood pressure in Remifentanil group was significantly more than in Alfentanil group (p<0.05). After laryngoscopy and tracheal intubation, all of the hemodynamic variables increased and returned to the basic value shortly. The decrease in Remifentanil group was significantly higher than in Alfentanil group (p<0.05) in the case of systolic blood pressure, diastolic blood pressure and the mean arterial pressure. There was no significant difference between two groups in the case of decrease in the heart rate after tracheal intubation (p>0.05). Morever the dose of ephedrine which is used to compensate the sever hypotension in Remifentanil group was significantly more (11 patients) than in Alfentanil group (4 patients) (p<0.05). According to the results of this study, we conclude that Remifentanil more than Alfentanil modifies the increase in the blood pressure resulted from laryngoscopy and tracheal intubation, but it produces more reduction in blood pressure during anesthesia. There was no significant difference between both drugs in the case of increase in heart rate after laryngoscopy and tracheal intubation.