Abstract: Objective To explore the efficacy and safety of remifentanil and fentanyl in obese patients.Methods 96 obese patients applied general anesthesia in our hospital from October 2012 to October 2013 were randomly equally divided into three groups by hidden numbers.They were used remifentanil,fentanyl,remifentanil fentanyl fentanyl anesthesia.The hemodynamics was compared in the three groups,using the visual analogue scale (VAS)and sedation /alertness score (OAA /S).Results Before induction,the difference was not significant in intubation MAP of three groups (P >0.05).MAP significantly increased after intubation in fentanyl group, compared with the combined group and remifentanil group .The difference was significant . (P <0.05).Compared with the fentanyl group,MAP in extubation remifentanil group signifi-cantly increased.joint group difference was significant (P <0.05).VAS score in Remifentanil group was significantly higher than that in the fentanyl group,OAA /S score in combined group and the fentanyl group was significantly lower than that in remifentanil group.The difference was significant with the comparison of different groups.(P <0.05).Conclusion The efficacy and safety of remifentanil and fentanyl anesthesia in obese patients have greater advantages.