Objective To evaluate Virtual Reality (VR) as a distraction technique to diminish pain perception and improve satisfaction in patients who underwent an outpatient hysteroscopy (OH). Design A prospective, parallel group, 1:1 randomized controlled trial. Setting Spanish University Hospital. Sample A total of 120 patients between 18 and 70 years old undergoing an outpatient hysteroscopy. Method A total of 120 patients were randomly allocated to undergo an outpatient hysteroscopy either with standard treatment with vocal-local support (n=60) or with the use of a VR device (n=60) between January and June 2022. Main Outcome Measures The primary outcome was worst and average patient reported pain score (0 to 10) during the procedure. The secondary outcome was patient satisfaction (1 to 5) with the OH and with the use of VR. Results Mean duration of the procedure (4.57 vs 5.63 min p=0.11) and procedure performed did not differ among groups. There were no statistically significant differences on worst pain perception (VAS score 4.83 vs 4.84 p=0.95) or average pain perception (VAS score 2.91 vs 3.21 p=0.41) between the standard care and the VR group. There were no statistically significant differences on patient satisfaction between both groups. Conclusions The use of VR was as effective as the standard care with vocal-local support to improve pain perception and patient satisfaction in patients undergoing OH. Funding This research was supported by the own funds of the Hysteroscopy and Minimally Invasive Surgery Unit. Keywords Virtual reality, pain, outpatient hysteroscopy, distraction technique, vocal-local, patient satisfaction, randomized controlled trial. Clinical Trial Registration ClinicalTrials.gov ID NCT06463210 URL:[https://clinicaltrials.gov/study/NCT06463210?cond=hysteroscopy%20virtual%20reality&rank=9](https://clinicaltrials.gov/study/NCT06463210?cond=hysteroscopy%20virtual%20reality&rank=9)