Background Dexmedetomidine (DEX) is a potent and highly selective α-2 adrenoreceptor agonist,it provides dose-dependent sedation,analgesia,anxiolysis and sympatholysis.It doesn't increase intracranial pressure and can provide good pereoperative homodynamic stability with decreased intraoperative anesthetics requirements,especial the opiates.In addition,DEX has displayed potential neuroprotective properties.Purpose The aim of this review was to outline the advances of the use of DEX and provide practical guidance in neurosurgery clinical anesthesia.Content From the aspects of mechanism of action and clinical application,we reviewed the pharmacological characteristics and neuroprotective effects of DEX.Trend As a new anesthetic adjuvant,the clinical application of DEX in neurosurgery anesthesia is quite promising.