Background: This study compared the effects of rosemary and ketamine gargling on voice hoarseness and sore throat after tracheal intubation. Methods: This clinical trial was conducted on 116 patients who required general anesthesia and were randomly divided into intervention (30 drops of rosemary extract and 40mg of ketamine) and control (30 mL distilled water) groups using Randomize Allocation software. The measurement methods for obtaining information in the current study included the Visual Analogue Scale (VAS) for pain, GRBAS (Grade of Hoarseness; Roughness, Breathiness, Asthenia, and Strain), the auditory scale for the severity of voice hoarseness, and a questionnaire to evaluate the patient’s level of satisfaction. Then, the data was imported into SPSS V. 25 after data gathering. Results: The results revealed that patients of the three groups did not indicate significant hemodynamic changes, including the parameters systolic blood pressure (P = 0.73), diastolic blood pressure (P = 0.97), SpO2 level (P = 0.6), and heart rate (P = 0.31). However, the sore throat pain intensity of the rosemary group was significantly lower (P = 0.0008). The difference in time of the first pain sensation significantly differed among the three groups (P = 0.011). However, the mean pethidine administration of the control group (P = 0.003) was significantly higher, and the control group's satisfaction level (P = 0.02) was significantly lower. Conclusions: Gargling rosemary solution and ketamine did not affect the voice hoarseness after tracheal intubation, but the rosemary group had lower sore throat pain intensity.