Although anesthesia during surgery prevents children from recalling actual surgical events, they are subjected to stressful events while preparing for surgery. One estimate suggests that 60% of children experience significant anxiety before anesthesia induction and surgery, and literature from around the world indicates that preoperative anxiety is a global concern for health care providers. The challenge that nurses face is to better manage children's anxiety in today's fast paced ORs. This article uses case studies to show nursing strategies that can be used to help allay the fears of children at different psychosocial stages of development.