Abstract:Background Painful medical procedures in childhood may have long-term negative effects on development and future tolerance of pain, evidence suggests that a significant number of children receive less than optimal management of procedure-related pain Objective The present study aim to investigate the efficacy of three interventions methods (Buzzy, distracting cards and balloon inflating) on mitigating pain and anxiety associated with venipuncture in a group of pediatric patients. Methods A prospective randomized clinical trial with children who required venipuncture and aged 7 to12 years was conducted in a pediatric ED. Data were obtained by conducting interviews with the children, their parents, and the observer. The pain levels of the children were assessed by the parent, observer as well as self-report using the Faces Pain Scale-Revised (FPS-R). The anxiety levels of children were assessed using Children Fear Scale (CFS). Results One hundred and eighty children (mean age, 9.3±1.9 years) were included. The pain levels of children showed statistically significant differences between the groups in the self-, observer-and parent-reported procedural pain (p = 0.012, p = 0.036, p = 0.014 respectively).No significant differences were observed between the groups in procedural child anxiety levels according to the parents and observer (p =0. 42, 0.13 respectively). Conclusion The results of the study suggests that the distraction method through Buzzy, distraction cards and balloon inflating are effectively decreased pain levels of children compared with the control group according to self-report, parent-report and observer-report.