Background: Dental anxiety is one of the causes of avoiding dental visits in children and is associated with physiological body reactions as increased heart rate. Different behavior management techniques have been used to reduce dental anxiety among them are Tell-show-do technique and audiovisual (AV) distraction. Aim:To determine the effect of audiovisual distraction on heart rate during dental treatment in children. Subjects and methods:Forty-two patients requiring pulp therapy were randomly allocated to either control group (managed by tell-show-do technique) or test group (managed by audiovisual distraction using virtual reality eyeglasses). Heart rate measures were recorded for all patients before the treatment and every five minutes during the procedure. Results were tabulated and statistically analyzed.Results: There was a statistically significant difference in heart rate mean values between both study groups. Where AV distraction group showed better results in lowering anxiety. Conclusions:Audiovisual distraction can be considered an effective method for reducing anxiety during dental treatment and helping the patients enjoy the dental visit.