Objective To investigate the effects of dexmedetomidine on the recovery quality of patients undergoing intracranial aneurysm embolization. Methods A total of 140 patients, American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, Hunt‑Hess grades 0 or Ⅰ, who were scheduled for intracranial aneurysm embolization were enrolled. According to the random number table method, they were randomly divided into three groups: a nasal dexmedetomidine group (group A, n=45, which was nasally administered with 0.5 μg/kg of dexmedetomidine 10 min before anesthesia induction), an intravenous dexmedetomidine group (group B, n=47, which was intravenously infused with dexmedetomidine at a rate of 0.4 μg·kg−1·h−1, 10 min before anesthesia induction until the end of surgery), and a blank control group (group C, n=48, without administration of dexmedetomidine). The Ricker's sedation‑agitation score and the grade of cough during the recovery period were recorded. The mean arterial pressure (MAP) and heart rate were determined before anesthesia induction (T0), before intubation (T1), after intubation (T2), 1 min after intubation (T3), before aneurysm embolization (T4), at the end of embolization (T5), when the eyes opened (T6), at extubation (T7), and 2 min after extubation (T8). The intraoperative dosage of propofol and remifentanil, the time from withdrawal to extubation, the levels of blood glucose and lactic acid before and after embolization of the aneurysms, the Mini‑Mental State Examination (MMSE) 24 h before and 24 h after surgery and complications like hypoxia [pulse oxygen saturation (SpO2)<90%] and laryngospasm during the recovery period were recorded. Results Compared with group C, group B presented decreases in the incidence of cough and agitation during the recovery period (P<0.05), while no significant difference was found in group A (P>0.05). Compared with those at T0, decreases in MAP were found in group A at T1, T3, T4 and T5, and in group B at T1, T3 and T4 (P<0.05), while no statistical difference was found in heart rate among the three groups at each time point (P>0.05). Compared with those at T5, groups A and C presented remarkable increases in MAP at T6, T7 and T8, and in heart rate at T7 and T8 (P<0.05), while no statistical difference in MAP and heart rate was found in group B (P>0.05). Compared with group B, groups A and C showed increases in heart rate at T8 (P<0.05), while no statistical difference was found in MAP among the three groups at T6, T7 and T8 (P>0.05). There was no statistical difference in the maintenance dosages of propofol and remifentanil, the time from withdrawal to extubation, and MMSE scores 24 h before and 24 h after operation among the three groups (P>0.05). Compared with those before embolization, there was no statistical difference in blood glucose between groups A and B after embolization (P>0.05). The blood glucose index remarkably increased in group C at the end of embolization (P<0.05). Compared with those before embolization, there was no statistical difference in lactic acid after embolization among the three groups (P>0.05). There were no complications such as hypoxia and laryngospasm during the recovery period. There were no complications such as hypoxia and laryngospasm among the three groups during the recovery period. Conclusions For intracranial aneurysm embolization, intravenous infusion of dexmedetomidine can effectively maintain hemodynamic stability during the surgery and the recovery period, reduce the incidence of cough during the recovery period, and improve recovery quality, without increases in the recovery time.