Purpose of review: Virtual reality (VR) is a promising tool that is becoming increasingly popular for the prevention and treatment of procedural pain in children. This review aims to investigate the current literature on the use and effectiveness of VR in paediatric procedural pain management, focusing on needle-related procedures, burn wound care, dental procedures among others; limitations and future perspectives on the use of VR will also be highlighted. Recent findings: in addition to the most researched fields of application (e.g. needle procedures), VR has also started to be used in new areas, such as nasal and gastrointestinal endoscopies as well as minor surgeries. From the latest evidence, VR seems to be effective in many procedures, especially compared to no distraction; however, there is conflicting data in the literature due to numerous factors such as differences between technologies, degree of VR-immersion, patients coping styles among others. Summary: there are still no data of absolute certainty on the effectiveness of VR in reducing procedural pain in paediatric patients and data pooling is still difficult. Future research should carry on large randomised-controlled, multicentre studies to better define VR properties and how best to optimise VR software and user experience for maximum pain reduction.