Post operative sore throat and hoarseness are common complications after endotracheal intubation. We conducted an experimental, randomized, double- blind study to compare the effectiveness of preoperative nebulisation with ketamine, budesonide and lignocaine in reducing the incidence and severity of post operative sore throat. MATERIAL & METHODS 120 patients (aged 20-60 years) scheduled for elective surgery under general anaesthesia were enrolled. Preoperatively , patients were nebulized with ketamine (Group 1) , Budesonide (Group 2 ) , Lignocaine (Group 3 ) and distilled water (Group 4). Number of attempts required for intubation, duration of laryngoscopy and anaesthesia were recorded. Patients were evaluated post operatively at various time intervals for sore throat, hoarseness and cough, pain and signs of mucositis in laryngopharynx. RESULTS The incidence of sore throat at different time intervals was found to be least in ketamine group at 1 hr, by lignocaine at 24 hrs and budesonide at 48 hrs.. Lignocaine reduced cough at 1 and 24 hrs. Incidence of hoarseness was comparable in all the groups. CONCLUSION Nebulisation with lignocaine was efficacious in reducing cough , and ketamine reduced sore throat in early post operative period , whereas long term outcome was better with budesonide.