Ninety-five pediatric patients aged 5–17 years undergoing orthopedic procedures were randomized to receive either virtual reality (VR) distraction therapy (n=48) or standard care (n=47). The primary outcome was the change in maximum heart rate during the procedure compared to baseline. Secondary outcomes included pain measured by the Wong Baker FACES Rating Scale and anxiety measured using a Visual Analog Scale (VAS). Outcomes were assessed during the procedure and immediately after. Overall, the study revealed that the VR group had significantly lower heart rate changes and trends toward reduced pain and anxiety scores, though these secondary outcomes were not statistically significant. The findings suggest VR is a promising tool to mitigate anxiety and pain in pediatric orthopedic settings.