Objective
To evaluate the effectiveness of virtual reality as a distraction technique in the management of acute pain and anxiety during outpatient hysteroscopy.

Design
Parallel group, prospective randomised controlled trial.

Setting
UK University Hospital.

Methods
Forty consenting, eligible women were randomised to virtual reality intervention (immersive video content as a distraction method) or standard care during outpatient hysteroscopy from August to October 2018.

Main Outcome Measures
Pain and anxiety outcomes were measured as a numeric rating score (scale of 0‐10).

Results
Compared to standard care, women with virtual reality intervention experienced less average pain (score 6.0 vs. 3.7, mean difference 2.3, 95% CI 0.61‐3.99, p=0.009) and anxiety (score 5.45 vs. 3.3, mean difference 2.15, 95% CI 0.38‐3.92, p=0.02).

Conclusion
Virtual Reality was effective in reducing pain and anxiety during outpatient hysteroscopy in a mixed‐methods randomised control trial. Its wide potential role in ambulatory gynaecologic procedures needs further evaluation.