Background <p>A novel sedative agent, remimazolam, has recently been introduced for dental sedation. Synthesis of the available clinical knowledge in dental sedation was considered important.</p> Purpose <p>This systematic review and meta-analysis was conducted to evaluate whether remimazolam is superior to midazolam and propofol for intravenous sedation during oral surgery in terms of reduced onset time, time to discharge, and incidence of adverse events.</p> Study Selection <p>A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) (last search date: February 2025). English-language clinical studies assessing the effectiveness of remimazolam for intravenous sedation during oral surgery were included. Multiple reviewers independently extracted data, and of 32 studies screened, 5 studies (5/32, 15.6%) involving 398 patients met the inclusion criteria. Meta-analysis was performed using Cochrane Review Manager Web with a random-effects model, reporting effect sizes as mean differences and odds ratios.</p> Results <p>As the primary outcomes, remimazolam intervention demonstrated a similar time to onset and time to discharge compared with other sedatives. However, a lower incidence of adverse events was observed (odds ratio, 0.26; 95% confidence interval, 0.05–1.39; I² = 61%).</p> Conclusion <p>Remimazolam would provide comparable sedative efficacy for intravenous sedation during oral surgery, with a potential safety benefit of fewer adverse events.</p>