This research was completed to determine the effect of a musical toy (xylophone) on pain and fear in children and parental satisfaction during peripheral venous access in children. This research was completed as a randomized controlled trial study. The sample for the research comprised 70 children (control: 35, experiment: 35) aged 3–6 years with peripheral venous access who were admitted to the Pediatric ward and their parents abiding with case selection criteria. The mean Children's Emotional Manifestation Scale score for children in the experiment group was found to be statistically significantly lower than in the control group (p < 0.05). Children in the experiment group had statistically significantly different mean Children's Fear Scale scores, which were found to be low (p < 0.05). No statistically significant difference was found between the pain scores of the experimental and control groups (p > 0.05). There was a statistically significant difference present for patient cooperation with the nurse in the experiment group (p < 0.05). Though the use of a musical toy during the peripheral venous access procedure had positive impacts on fear and emotional symptoms in the child, it did not appear to have any effect on the child's pain level or parental satisfaction. The use of a xylophone during painful procedures performed on children is recommended in terms of reducing the negative impact of the procedure on children by ensuring the child and parent focus on each other during the procedure and the parent contributes to care. •There are interventional studies using several non-pharmacological methods for pain and fear developing during peripheral venous access interventions in children.•The study was completed with the aim of determining the effect of the use of xylophone during the peripheral venous access procedure on fear and pain of the child.•The use of xylophone during painful procedures for children may be recommended because it reduces the negative effects of the procedure on the child by allowing the parent and child to focus on each other during the procedure.