Purpose: Virtual reality (VR) is a nonpharmacological method used in healthcare settings. This study aimed to determine the effectiveness of distraction through VR on pain and anxiety during fine needle aspiration (FNA) breast biopsy. Design: This was a randomized controlled trial. Methods: A total of 60 Turkish females undergoing FNA breast biopsies were randomly divided into two groups. The patients in the experimental group (n = 30) viewed a specific scenario using VR from one minute before the procedure to the end of the procedure. The patients in the control group (n = 30) were subject to a standard protocol in which no anesthetic was given during the procedure. Immediately after the implemen-tation of the FNA breast biopsy, the pain scores of all patients in groups were measured with the Visual Ana-logue Scale (VAS), and their anxiety levels were assessed with the State-Trait Anxiety Inventory. Findings: A statistically significant difference was determined between the post-procedure mean pain scores and average state anxiety scores of the patients in the experimental and control groups (P < .001). Conclusions: The use of VR during FNA breast biopsy is effective in reducing pain and anxiety in adult female patients. (c) 2021 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.