Exodontia, the most common dental procedure for damaged or decayed teeth, often utilizes local anesthesia with vasoconstrictors like adrenaline. Although effective, adrenaline can impact blood glucose levels and hemodynamic parameters, particularly in hypertensive and diabetic patients. Objectives: To compare changes in blood pressure and blood glucose levels among healthy, hypertensive and diabetic patients undergoing tooth extraction with adrenaline-containing local anesthesia. Methods: A total of 177 participants were split equally into three groups: healthy, hypertensive and diabetic. Prior to and twenty minutes’ post-injection, blood pressure, and blood glucose levels were measured while a local anesthetic containing 2% lignocaine HCL with 1: 100,000 adrenaline was administered. Sample paired t test and one-way ANOVA were employed in the analysis. Results: Among hypertensive patients, random blood glucose significantly decreased post-procedure (p=0.001), while systolic blood pressure significantly increased (p<0.001) and diastolic blood pressure significantly decreased (p=0.021). Diabetic patients showed a non-significant decrease in glucose levels (p=0.209) but a significant increase in both systolic (p<0.001) and diastolic blood pressure (p=0.002). Healthy patients experienced a significant increase in systolic blood pressure (p=0.015) but no significant changes in glucose levels (p=0.873) or diastolic pressure (p=0.301). Conclusions: Adrenaline in local anesthesia significantly increases systolic blood pressure in all patient groups, with pronounced effects in hypertensive and diabetic patients. Changes in blood glucose were significant only in hypertensive patients, while changes in diabetic patients were non-significant. These findings highlight the need for careful monitoring and personalized management strategies in dental procedures to minimize potential adverse effects and ensure patient safety.