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Background & Aim: Tracheal tubes are designed to provide a pathway through the upper airway. The aim of this study was to compare the frequency of post-extubation stridor and the rate of tracheal tubes and hemo-dynamic changes in cuffed versus uncuffed tubes in small children. Methods: In this clinical trial two hundred patients, aged 4-6 years, requiring general anesthesia for elective orthopedic or abdominal surgery were randomly assigned to receive either cuffed or uncuffed tubes. Same drugs were administered to patients in both groups for the induction of anesthesia and incidence of post-extubation stridor, and the number of tracheal tube changes, 1 and 5 minutes after extubation were recorded in both groups. The hemodynamic variables, arterial blood oxygen saturation, respiration rate and number were also evaluated. Data were analyzed using Student t test, chi-square and Fisher exact test. Results: The mean age of children in was 59 months in the cuffed (101 children) and 61 month in the uncuffed (99 children) group. Post extubation stridor was noted in 2.9% of uncuffed and 9.2% of the cuffed group (p=0.06). Tracheal tube exchange rate was 10.9% in uncuffed and 7.1% in cuffed group (p=0.34). Conclusion: The use of cuffed tracheal tubes in children of 4-6 years old did not increase the risk of post-extubation stridor, and did not change the hemodynamic responses such as SPO2, respiratory rate and pulse rate in our study.