Intravenous catheter insertion is an invasive procedure that often causes anxiety in preschool-aged children, characterized by crying, fear, refusal of treatment, and uncooperative behavior. One non-pharmacological intervention that can be used to reduce anxiety is audio-visual distraction through watching animated cartoons. Objective of this study is To determine the effect of audio-visual distraction on the anxiety level of preschool-aged children during intravenous catheter insertion at the Pediatric Ward of RIS Hospital South Tangerang. This study employed a pre-experimental design with a One Group Pretest-Posttest Design approach. The sample consisted of 30 preschool-aged children (3–6 years old) selected using a purposive sampling technique. Anxiety levels were measured using the Spence Children's Anxiety Scale (SCAS). Data were analyzed using the Wilcoxon Signed Rank Test. Before the intervention, most respondents experienced severe anxiety (66.6%). After receiving the audio-visual distraction intervention, the majority experienced mild anxiety. The mean anxiety score decreased from 58.40 to 32.10. The Wilcoxon Signed Rank Test showed an Asymp. Sig. (2-tailed) value of 0.001 (p < 0.05), indicating a significant effect of audio-visual distraction on the anxiety level of preschool-aged children during intravenous catheter insertion. Audio-visual distraction through watching animated cartoons is effective in reducing anxiety levels among preschool-aged children during intravenous catheter insertion and can be used as a non-pharmacological nursing intervention in pediatric wards
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