The prevalence of dental fear is ubiquitous and so is the need; to remove fear and anxiety. Depression of the individual__ampersandsignrsquo;s consciousness during the treatment aids tremendously in a positive patient outcome. It also contributes to a better overall oral health of the community. All the sedative agents of old have either caused more harm than good or failed in their effectiveness. With the introduction of midazolam in1975 sedation has not only become safe but also highly effective. Midazolam acts by enhancing the activity of the GABA receptors in the central nervous system. Alongside the sedative effect, the drug shows anxiolytic, muscle relaxant, anticonvulsant, hypnotic and amnesic properties. Literature supports the use of midazolam as an emergency drug for seizures, for conscious sedation and as a part of the pre-anaesthetic medication. Midazolam has been used extensively to achieve positive behaviour in children undergoing dental therapy. Certain side effects have been reported with the use of this drug. With modern delivery systems such as Mucosal Atomization Device (MAD), the rapidity of onset of the drug is enhanced along with a reduction of the dose. This review article stands as a testimony to the use of midazolam in dentistry.