Objective To observe the value of propofol combined with etomidate in bariatric surgery based on hemodynamics and stress response.Methods Patients admitted to Shanxi Bethune Hospital who underwent bariatric surgery from January 2020 to January 2021 were retrospectively selected and divided into an experimental group (propofol combined with etomidate) and a control group (propofol) according to the intraoperative anesthesia regimen.The patient's surgical time,awakening time,extubation time,hemodynamic indicators[heart rate (HR),mean arterial pressure (MAP),blood oxygen saturation (SpO2)],stress indicators[adrenocorticotropic hormone (ACTH),adrenaline (ADR),cortisol (COR)],Mini Mental State Examination (MMSE) score,and adverse reactions were recorded.Results A total of 80 patients were included in the study,among which 47 cases were in the experimental group,and 33 cases were in the control group.There was no statistically significant difference in operation time,awakening time and extubation time between the two groups (P>0.05).Immediately after intubation,HR and MAP of the experimental group were lower than those of the control group,and SpO2 was higher than that of the control group (P<0.05).Serum ACTH,ADR and COR levels in the experimental group were higher than those in the control group immediately after intubation and 5 min after extubation (P<0.05).The MMSE score of the experimental group 10 min after awakening was higher than that of the control group (P<0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant (P>0.05).Conclusion The use of propofol combined with etomidate in weight loss surgery can reduce hemodynamic fluctuations,alleviate cognitive impairment,alleviate stress reactions,and does not significantly increase anesthesia adverse reactions,which is with good safety.