Objective：To compare the hemodynamic effects of propofol and remimazolam during the perioperative period in Stanford type B aortic dissection patients. Methods：Eighty patients were randomized to receive propofol（Group P）or remimazolam（Group R） for anesthesia. Mean arterial pressure（MAP）and bispectral index（BIS）values were recorded at anesthesia onset（T0），tracheal intubation（T1），5 minutes after intubation（T2），procedure completion（T3），airway extubation（T4），and 5 minutes after airway extubation（T5）. The percentage change in MAP during anesthesia induction and the peri - extubation period were calculated and compared between the two groups. Results：No significant differences in BIS values were observed between the two groups at any time point（P ＜ 0.05）. During anesthesia induction，the percentage change in MAP was higher in Group P（22.6%±6.5%）compared to Group R（13.7%±6.9%），with a statistically significant difference（P ＜ 0.001）. Similarly，the average percentage change in MAP during the peri - extubation period was higher in Group P（21.3% ± 6.2%）than in Group R（11.7% ± 5.8%），showing a statistically significant difference（P ＜ 0.001）. Conclusion：Remimazolam exerted a milder cardiovascular depression effect compared to propofol when delivering same sedation，which has certain positive significance for reducing perioperative complications in these patients.