Objective: To investigate the efficacy and safety of butorphanol combined with remifentanil for analgesia under fiberoptic bronchoscopy. Methods: A total of 108 patients who undergoing fiberoptic bronchoscopy in Second Affiliated Hospital of Air Force Medical University from May 2018 to April 2019 were randomly divided into the remifentanil group (group R), butorphanol group (group B) and remifentanil combined with butorphanol group (group RB) by the random number table method. The group R, group B and group RB were respectively given remifentanil, butorphanol and remifentanil plus remifentanil as analgesic drugs, and all three groups were combined with propofol. Heart rate (HR), mean arterial pressure (MAP), disappearance time of eyelash reflex, Steward score during resuscitation and postoperative incidence of cough, nausea, vomiting, chills, lethargy and dizziness of the three groups were compared. Intraoperative and postoperative tachycardia, bradycardia, high blood pressure, low blood pressure and respiratory depression in each group were recorded. Results: Compared with patients in group R, the disappearance time of eyelash reflex in group B and group RB was shorter (P<0.05), and the incidence of intraoperative nausea and vomiting was lower (P<0.05). Compared with patients in group B, patients in group R and RB recovered more quickly after surgery (P<0.05), and the incidence of postoperative dizziness was lower (P<0.05). There was no significant difference in other adverse reactions among the three groups (P>0.05). No significant difference in hemodynamics between the three groups (P>0.05). Conclusion: Remifentanil combined with butorphanol provided adequate pain relief and fewer complications when used in fiberoptic bronchoscopy.