The Perfusion index (PI) is a continuous, non-invasive, cost effective, indirect measure of peripheral perfusion, monitored by photoplethysmography. It has been suggested that PI can be used as a complimentary haemodynamic parameter for early detection of haemodynamic instability in trauma and critically ill patients, in lieu of it being a valuable adjunct for early detection of acute hemodynamic responses to central hypovolemia. Stress response during intubation and extubation during general anaesthesia is known to cause a change in the peripheral vasomotor tone, leading to haemodynamic changes. There is an associated increase in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). This increase in the peripheral vasomotor tone, leads to a decrease in peripheral perfusion, and is thereby, expected to cause an associated fall in the PI. There is paucity of literature with regard to changes in perfusion index and haemodynamic parameters during tracheal intubation and extubation in adult patients undergoing elective surgery under general anaesthesia. Our study hypothesis is that perfusion index  changes  with haemodynamic parameters during tracheal intubation and extubation in adult patients undergoing elective surgery under general anaesthesia. The aim of our study is to study changes in  perfusion index and haemodynamic parameters   during tracheal intubation and extubation in adult patients undergoing elective surgery under general anaesthesia.