Objective To investigate the effects of nalbuphine combined with dexmedetomidine on postoperative recovery quality and pain in patients who undergoing laparoscopic bariatric surgery. Methods A total of 169 patients who underwent laparoscopic bariatric surgery at our hospital were included and divided into control group （group C）， nalbuphine group （group N）， dexmedetomidine group （group D）， and nalbuphine combined with dexmedetomidine group （group ND） using randomised numerical table method. Group C received intravenous injection of saline， group N and group ND received intravenous injection of nalbuphine before the end of the surgery， and group D and group ND received pumping of dexmedetomidine before anesthesia induction and during surgery. Compare the postoperative recovery quality score （QoR?40）， hemodynamics at different time points， visual analogue scale score （VAS）， sedation?agitation scale （SAS）， first time out of bed activity and exhaust time， and incidence of nausea and vomiting among four groups. Results The postoperative QoR?40 scores of patients in group ND were better than those in group C and group N （P < 0.05）， and the QoR?40 scores in group D were better than those in group C （P < 0.05）. MAP and HR were more stable during the awakening period in group ND and group D （P < 0.05）. Compared with group C， patients in all three groups had lower VAS scores and SAS scores （P < 0.05） and consumed less remedial analgesic medication（P < 0.05）. In terms of adverse reactions， the incidence of postoperative nausea， vomiting and coughing in the group ND was lower than that in the group C （P < 0.05）. Conclusion The combination of nalbuphine and dexmedetomidine could improve the quality of postoperative recovery and pain in patients undergoing laparoscopic bariatric surgery， reduce hemodynamic fluctuations during the patients′ recovery period， reduce the incidence of nausea and vomiting， and improve the patients′ prognosis.