INSERTION OF AN IV CATHETER is a commonly performed and painful procedure. The use of cognitive-behavioral interventions (CBIs) may decrease pain by diverting the patient’s attention to stimuli other than pain. THIS RANDOMIZED, CONTROLLED TRIAL examined the effect of three CBIs—music, kaleidoscope, and guided imagery—on IV insertion pain in 324 patients. NO STATISTICALLY SIGNIFICANT differences in IV insertion pain were found among the treatment and control groups or between choosing versus being assigned a CBI. Insertion attempts were more difficult in women, and insertion difficulty was correlated with pain intensity and pain distress. Pain intensity was related to insertion site and catheter gauge.