Background: Dental anxiety is a common problem, which can affect people of all ages, but appears to develop mostly in childhood. Practitioners use numerous methods to control dental anxiety in children during the dental procedures. Objective: To evaluate the effectiveness of nitrous oxide/oxygen (N2O/O2) inhalation sedation and video-eyeglass distraction (VED) in the management of anxious pediatric patients during dental extraction. Methods: The study was conducted on 40 children aged 6-12 years who required extraction of at-least one mandibular primary molar under local anesthesia. The children were randomly divided into two groups with 20 children in each -Group-A wearing videoeyeglass and Group-B using N2O/O2 inhalation sedation during dental extraction. The physiological assessment was done by recording heart rate using fingertip pulse oximeter. The psychological assessment was done by recording base line anxiety before the treatment and post treatment anxiety at the completion of extraction using Venham's anxiety scale (VAS). Independent t-test with p value <0.05 level of significance was used to compare means of two groups. Results: Comparison of Venham's anxiety score of participants at the completion of extraction, showed statistically no significant difference (p=0.946). The mean pulse rate recorded at different time points between the two groups was also statistically non-significant (P=0.923, 0.957, 1.00 respectively). Conclusion: Both N2O/O2 inhalation sedation and VED were equally effective in reducing anxiety during dental extraction but considering the adverse effects and requirement of expert personnel in N2O/O2 inhalation sedation, VED may be preferred because of its better applicability.