Abstract: Objective To investigate the effect of remimazolam on emergence agitation in children undergoing tooth decay treatment after sevoflurane anesthesia.Methods A total of 90 children, aged 3-7 years, ASA gradeⅠ—Ⅱ, who were scheduled for tooth decay treatment under general anesthesia in Xuzhou Children′s Hospital, Xuzhou Medical University from September 2021 to August 2022 were enrolled. According to the random number table method, they were divided into three groups(n=30): group R1, group R2 and group C. The three groups were intravenously injected with 0.1 mg/kg remimazolam, 0.2 mg/kg remimazolam and an equal volume of normal saline respectively 5 min before the end of surgery. Their pediatric anesthesia emergence delirium(PAED) scale scores, the face, legs, activity, cry and consolability(FLACC) scale scores, the Ramsay sedation scores were recorded, while the incidence of emergence agitation was calculated. The postoperative extubation time, eye opening time, and the length of PACU stay were recorded for the three groups.Results Compared with group C, the PAED scores and the incidence of emergence agitation were significantly reduced in groups R1 and R2(P＜0.05). Compared with group C, the Ramsay sedation scores significantly increased in group R2 0.5 h after PACU stay(P＜0.05). Compared with groups C and R1, the extubation time, eye opening time and the length of PACU stay in group R2 were significantly extended(P＜0.05).Conclusions Intravenous infusion of remimazolam at 0.1 mg/kg can significantly reduce the incidence of emergence agitation in children undergoing tooth decay treatment under sevoflurane anesthesia, without effect on recovery from anesthesia.