Objective To investigate the effect of sub-anesthetic dose Esketamine on Propofol injection pain prevention in painless hysteroscopic patients.Methods A total of 60 patients undergoing painless hysteroscopy in Jiexi County People's Hospital from August 2021 to January 2024 were selected as the study objects,and they were divided into group E and group C by random number table method,with 30 cases in each group.Both groups were given intravenous Propofol 2.5 mg/kg for anesthesia induction,and Propofol 4-10 mg/(kg·h)for anesthesia maintenance.Group E was given Esketamine 0.125 mg/kg intravenously at 15 min before Propofol,and group C was given the same amount of normal saline.The occurrence of injection pain,the dosage of Propofol,the time of recovery,the time of leaving the resuscitation room,and the occurrence of anesthesiation-related adverse reactions were compared between the two groups.Results The incidence of injection pain in group E was lower than that in group C(P<0.05).The dosage of Propofol in group E was lower than that in group C(P<0.05).There was no significant difference in the time of recovery and the time of leaving the resuscitation room between the two groups(P>0.05).There were no anesthesiation-related adverse reactions such as respiratory depression,nightmares,and increased oral secretions in both groups.Conclusion The sub-anesthetic dose of Esketamine can effectively reduce the pain of Propofol injection in patients undergoing hysteroscopic,without delaying the time of recovery and the time of leaving the resuscitation room.