Introduction: Dental anxiety leads to undesirable distresses among caregivers that affect the treatment quality. Thus the aim of this study was to evaluate the effectiveness of active and passive distraction using audiovisual distraction (AV). Method: 60 children patients who presented for treatment and met inclusion criteria were included and randomly divided into three groups; a control group, active distraction group and a passive distraction group. Anxiety and cooperative behaviour was assessed with the Wong–Baker Faces Pain Rating Scale and pulse rates. Results: Statistically significant differences were found among the three groups. Pulse rate and anxiety was significantly decreased in the active audiovisual distraction group (p<0.001). Conclusion: Active AV distraction is an effective method in reducing fear and anxiety in children during dental treatment