Background: Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology helps distract and engage young patients during dental procedures, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. Methods: A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS, and Web of Science databases were searched and analysed. Results: Search queries identified a total of 525 abstracts from three different databases. Duplicate articles were removed (n=79), leaving a total of 446 abstracts. After reading the title and abstract, 392 records were excluded. In the end, 22 articles were considered suitable for this systematic review. Conclusions: VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. By offering an engaging and immersive experience, VR effectively diverts patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is crucial to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.