Objective To investigate the effects of dexmedetomidine on stress in patients undergoing gynecological laparoscopic surgery under general anesthesia with endotracheal intubation. Methods From May 2019 to May 2022, a total of 90 patients undergoing gynecological laparoscopic surgery under general anesthesia with endotracheal intubation were selected and randomly divided into 3 groups, namely Group A （dextrometomidine 0.2 μg/kg, n=30）, Group B （dexmedetomidine 0.4 μg/kg, n=30）, and Group C （dexmedetomidine 0.6 μg/kg, n=30）. The differences of stress index, serum norepinephrine, and adrenaline levels 5 min before induction, 5 min after intubation, and at the completion of surgery were analyzed. Results There was no significant difference in SpO₂ level among the three groups at three time points （P>0.05）. There were no significant differences in MAP and HR among the three groups 5 min before induction and 5 min after intubation （P>0.05）, except at the completion of surgery （P<0.05）. There was no significant difference in serum norepinephrine level among the three groups 5 min before induction （P>0.05）, but the level in Group B was significantly lower than those in other groups 5 min after intubation and at the completion of surgery （P<0.05）. The adrenaline level varied in the same manner as the norepinephrine level （P<0.05）. Conclusion Dexmedetomidine can reduce the stress response of patients undergoing gynecological laparoscopic surgery under general anesthesia with endotracheal intubation, and decrease the levels of serum norepinephrine and adrenaline, which is worthy of clinical promotion.