This randomized controlled trial was conducted to evaluate the effects of virtual reality and tablet-based audiovisual distraction on pain, anxiety, and fear in children undergoing intravenous cannulation in a pediatric emergency department. Children aged 7 to 12 years were randomly assigned to three groups: virtual reality, tablet, and control. During intravenous cannulation, children in the virtual reality group watched an entertaining video using a virtual reality headset, while children in the tablet group watched the same video on a tablet. Children in the control group received routine care without an audiovisual distraction intervention. Pain, anxiety, and fear were assessed using age-appropriate validated scales. The study compared the effects of the two distraction methods with routine care and with each other.