Objective To evaluate the sedative effect of continuous intravenous infusion of midazolam in treating severe dental phobia. Methods 31 patients with severe dental phobia were enrolled and all of them had good communication with dentists. Two teeth in each patient were assigned to control group and experiment group seperately. The control group received root canal therapy. The experiment group were sedated by intravenous midazolam and received root canal therapy. The treat dependence and behavior therapy efficacy were evaluated. The vital signs and side effects during treatment were noted. Results Continuous intravenous infusion of midazolam showed a significant good sedative effect on patients with severe dental phobia. There were statistical difference in the Houpt score and the Frankl score between experiment group and control group(z=- 4.846, P=0.000;z=- 4.907, P=0.000). The total dose of midazolam was(9.58±3.76)mg, and mean infusion rate was(0.28±0.06)mg·kg- 1·h- 1. The blood pressure, heart rate and respiration of experiment group were depressed. But these changes didn′t interfere with the completion of the whole treatment. No severe side effects were detected. Conclusion The single use of midazolam as an intravenous sedation agent has satisfactory effect on patients with severe dental phobia.