Objective To analyze the clinical value of dexmedetomidine+tumescent anesthesia in cosmetic plastic surgery. Methods From January 2022 to February 2023,76 patients undergoing elective cosmetic plastic surgery in Heze Haijiya Hospital were selected and divided into control group and observation group by random number table method, with 38 patients in each group. Propofol+tumescent anesthesia was used in the control group, and dexmedetomidine+tumescent anesthesia was used in the observation group. The hemodynamic indexes [heart rate (HR), mean arterial pressure (MAP)], related anesthesia quality indexes [sufentanil dosage, awake time, Visual Analogue Scale (VAS)] and adverse reactions of anesthesia were compared between the two groups. Results There was no significant difference in HR and MAP between the two groups at T0 (P >0.05). HR and MAP at T1 and T2 in the observation group were lower than those in the control group (P <0.05). The dosage of sufentanil in the observation group was less than that in the control group, the awake time was shorter than that in the control group, and the VAS score at 30 min after operation was lower than that in the control group (P <0.05). Theincidence of adverse reactions of anesthesiain the observation group was lower than that in the control group (P <0.05). Conclusion Dexmedetomidine+tumescent anesthesia in cosmetic plastic surgery can effectively improve the quality of anesthesia, maintain the hemodynamic stability of patients during operation, reduce the amount of anesthetic drugs, and improve the safety of anesthesia.