Objective: To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs. Methods: A total of 60 pediatric patients undergoing elective surgery admitted to our hospital from January to August 2025 were selected and randomly divided into an observation group and a control group, with 30 cases in each group, using a random number table method. The control group received an intravenous infusion of 0.9% sodium chloride injection 30 minutes before the end of surgery, while the observation group received an intravenous pump infusion of dexmedetomidine (1 μg/kg, diluted to 4 μg/ml with normal saline). The severity of cough (graded from 0 to 3) and vital signs, including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse oxygen saturation (SpO₂), were recorded 5 minutes before extubation, at the time of extubation, and 5 minutes after extubation in both groups. Results: The severity of cough in the observation group was significantly milder than that in the control group (P < 0.05), with a significantly higher proportion of grade 0 cough in the observation group (23.33% vs 3.33%). At extubation and five minutes post-extubation, the observation group exhibited significantly lower HR, SBP, and DBP than the control group (P < 0.05). In contrast, SpO₂ levels remained comparable between the groups (P > 0.05). Conclusion: Dexmedetomidine can effectively suppress the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia, reduce the severity of cough, stabilize hemodynamic parameters, and has no significant impact on respiratory function, demonstrating good clinical safety.