Background: Surgery as a stressful experience can affect the child and quality of care plan. Nurses can use non-pharmacological intervention to reduce anxiety and help children cope with this stress. Objectives: This study was designed to compare the effects of dramatic puppet and therapeutic play on anxiety of children undergoing surgery. Methods: In this randomized clinical trial, 75 children were divided into three groups (dramatic puppet, therapeutic play, and control) using a simple random allocation method. The study was conducted in Iran in 2013-2014. The revised children's manifest anxiety scale (RCMAS) was used to determine the anxiety of children. The data were analyzed using paired t-test, one-way analysis of variance (ANOVA), and Tukey test. Results: The findings revealed that the changes of anxiety scores after the intervention were significantly different among the three groups (P < 0.001), so that the anxiety scores decreased in both the intervention groups (puppet and play) and increased in the control group. Conclusions: Therapeutic play and dramatic puppet can be used by nurses as a care strategy and effective preoperative preparation intervention to reduce anxiety in children undergoing surgery.