Patient anxiety levels before impending endoscopy can lead to increased blood pressure and heart rate, apprehension and anxiety. As a result, patients may require additional sedatives and experience greater discomfort during a procedure. This study evaluated the effectiveness of listening to music in the preprocedure area as a means of decreasing patient anxiety. Method: Ninety-five patients undergoing a variety of endoscopies, including EGDs, flexible sigmoidoscopies and colonoscopies were randomly assigned to music intervention (N=48) or a control group (N=47). Demographic characteristics were similar in each group. Patients with hearing loss, diagnosed psychiatric disorders, and diagnosed hypertension were excluded. Patients' anxiety levels were obtained using the State Trait Anxiety Inventory (STAI) and by vital signs both before and after music intervention. Subjects listened to a selected tape from among several categories of music (classical, new age, or easy listening) for 15 minutes using cassette players with headphones. Controls rested or read during this period also with headphones (but without music) to minimize extraneous noise. All study subjects completed a patient satisfaction survey at the end of the intervention period. Results: Both the music group and controls showed improvement from baseline state anxiety scores as measured by STAI, but the improvement in state anxiety levels in the music group was significantly higher over controls (change in mean score of -5.6 vs. -2.4, p=0.039). Respiration rate improved dramatically in the music group (-1.8 breaths/min) while no change was experienced by controls (p=0.0002). Both groups also experienced decreased heart rates and systolic and diastolic blood pressures in the post-intervention period, but no significant differences were found between groups. Finally, 93% of the music group said on the patient satisfaction survey that music helped relax them, and they felt that music would be beneficial to them if repeat endoscopy was needed. Conclusion: Patients preparing to undergo endoscopy who were exposed to relaxing music experienced lowered state anxiety levels and respiration rates. Exposure to music also resulted in high levels of patient satisfaction. The findings from this study suggest that the use of music can be a cost-effective, noninvasive intervention for preparing patients for endoscopic procedures.