Abstract: The present study was conducted to evaluate the effect of scalp infiltration with Bupivacaine on hemodynamic responses during early stimulation in craniotomy under general anesthesia. Thirty six patients were prospectively randomized to receive Bupivacaine scalp infiltration (B group) or a saline control (S group) as an adjuvant to general anesthesia using isoflurane in 50% N2O-O2. Mean Arterial Blood Pressure (MAP) and Heart Rate (HR) were recorded as base line, after scalp incision or pin insertion and then every 3 min until 12 min. The measurements were repeated every 5 min till dura was opened. The mean difference between the two groups for HR during scalp incision or pin insertion was significant (p = 0.03). The mean MAP throughout the time intervals of preincision or pin insertion to 12 min postincision and then to dural opening were statistically different between the two groups (p = 0.001). No complications related to the technique of block or drugs were recorded. Scalp infiltration with Bupivacaine as an adjuvant to general anesthesia can provide more stable hemodynamics, as measured by HR and MAP changes during early stimulation in craniotomy.