Objective To evaluate the effect of remimazolam combined with desflurane and flumazenil antagonism for anesthesia during ophthalmic day surgery. Methods This is a prospective randomized controlled trial. A total of 64 patients undergoing elective general anesthesia with laryngeal mask during ophthalmic day surgery were selected and randomly assigned to propofol group （n = 32） and remimazolam group （n = 32）. The propofol group was given propofol anesthesia induction and propofol combined with diflurane anesthesia maintenance； the remazolam group was given remazolam anesthesia induction and remazolam combined with diflurane anesthesia maintenance， and flumazenil antagonism was given intravenously at the end of the operation. Continuous intravenous infusion of remifentanil was administered during surgery in both groups. The primary outcome was emergence time. The secondary outcome included changes in intraoperative hemodynamic parameters，extubation time，time to leaving the operating room， duration of postoperative recovery room （PACU） stay， and the occurrence of other perioperative adverse reactions. Results Emergence time， extubation time， and time to leaving the operating room in remimazolam group were significantly shorter than those in group propofol （P < 0.05） ［（4.11 ± 1.17） vs. （8.64 ± 2.77）min， （4.61 ± 1.11） vs. （9.90 ± 2.81）min and （6.60 ± 2.01） vs. （11.74 ± 3.11）min， respectively］. The incidences of intraoperative hypotension and bradycardia in the remimazolam group were significantly lower than that in the propofol group （P < 0.05）； There was no statistically difference in the duration of PACU stay and the incidence of postoperative complications between the two groups（P > 0.05）. Conclusion Remimazolam combined with desflurane general anesthesia and flumazenil antagonism for anesthesia management in ophthalmic day surgery could significantly shorten the time of emergence and extubation， help to maintain hemodynamic stability with fewer adverse reactions， and improve the safety of ophthalmic daytime surgery， which is worthy of clinical promotion and application.