Objective To explore an effective method for relieving pain and anxiety in patients undergoing colonoscopy. Methods Sixty patients undergoing colonoscopy were randomized into 3 groups of 20. The control group was given routine colonoscopy, the vir-tual reality (VR) group used VR headsets for listening to and watching videos chosen by patients themselves, and the awake group was sedated for awake colonoscopy. Vital signs were recorded throughout the procedure, pain and anxiety were also evaluated. Results The intensity of pain during the procedure and anxiety score after the procedure were significantly lower in the awake and VR groups compared with the control group (P＜0.05 for all). Conclusion Application of VR in colonoscopy can alleviate patients′ pain during the procedure and relieve their anxiety.