Objective: To study the effect of remifentanil combined with etomidate on systemic stress reaction during painless fiberoptic bronchoscopy. Methods: A total of 84 patients who received painless fiberoptic bronchoscopy in outpatient and ward of our hospital between May 2014 and October 2016 were selected as the research subjects and randomly divided into two groups, observation group of patients accepted remifentanil combined with etomidate anesthesia, control group of patients received surface anesthesia, and in various time periods of inspection (before, during and after inspection), serum was collected respectively to test stress indexes. Results: Before inspection, serum NE, E, ACTH, Cor, PRA, AT-II, ALD, CRP, TNF-α, IL-6 and MCP-1 contents were not significantly different between two groups of patients; during and after inspection, serum NE, E, ACTH, Cor, PRA, AT-II, ALD, CRP, TNF-α, IL-6 and MCP-1 contents of both groups of patients were significantly higher than those before inspection, and serum NE, E, ACTH, Cor, PRA, AT-II, ALD, CRP, TNF-α, IL-6 and MCP-1 contents of observation group were significantly lower than those of control group. Conclusion: Remifentanil combined with etomidate can significantly inhibit the activation of systemic stress reaction and the release of stress hormones during painless fiberoptic bronchoscopy.