Background: The purpose of this study is to investigate the effects of guided imagery on postoperative pain and comfort in geriatric orthopedics patients. Methods: This study was carried out with a randomized-controlled true experimental design. The population of the study included geriatric patients receiving treatment at the orthopedics and traumatology inpatient clinic of a university hospital. Based on random selection, the sample consisted of total of 102 patients, including 40 patients in the experimental group and 40 in the control group. The data were collected using a Personal Information Form, the Visual Analog Scale, and the General Comfort Questionnaire. Results: After the guided imagery intervention, the pain levels of the experimental group significantly decreased compared to their baseline pain levels (t = 4.002, P = 0.00). Their perceived comfort was also significantly improved (t = À5.428, P = 0.00). Although the perceived comfort of the control group decreased, this decrease was not statistically significant (t = 0.698, P = 0.489). Conclusion: It is recommended that guided imagery, which is an inexpensive and accessible method, be integrated into the nursing care process to reduce the pain and increase the comfort of geriatric orthopedics patients.