Objective to investigate the effect of bibliotherapy combined with topical anesthesia among pediatric patients during first- time bone marrow biopsy. Methods A historical controlled trial was initiated, with 60 cases in the control group, likewise the intervention group. The control group received routine nursing care, while the intervention group, in addition to routine nursing care, received the following intervention: they received topical anesthesia 1-2 hours before bone marrow biopsy,and were guided to read special bone marrow biopsy comic books which were designed through prior observation, expert consultation, and interviews. The pain scores, fear scores, heart rates, and procedural compliance were compared between the 2 groups. Results The procedural pain scores, medical fear scores, were significantly lower and the rate of procedural compliance were significantly higher in the intervention group than those of control group （P＜0.05，P＜0.01）. The heart rates before and during the procedure between the two groups showed no statistical difference （P＞0.05 for both）. Conclusion During the invasive procedure, the combination of bibliotherapy and topical anesthesia was effective and convenient in decreasing procedural pain and increasing compliance in children.