Children account for numerous ED visits each year, with the majority of children reporting pain or requiring painful procedures. The fast-paced, noisy environment, varying resources, and staff trained in taking care of pediatric patients make the ED a unique place to care for children in pain. Nonpharmacological interventions are an essential part of pain management. The purpose of this review was to examine what nonpharmacological interventions EDs are using for pain management in children ages birth to 18 years. A systematic literature search was conducted to examine nonpharmacological interventions used for pain management of children in EDs. Fourteen articles met the inclusion/exclusion criteria. Ten studies used distraction, 2 examined the use of sucrose, 1 explored cold application, and 1 looked at parental holding and positioning. Benefits of using nonpharmacological methods included decreased pain, distress, and anxiety reported by the parent, child, and/or observer. Findings suggest nonpharmacological interventions such as distraction, positioning, sucrose, and cold application may be helpful in pediatric pain management in the ED. Nurses can implement these methods independently when caring for children and their families. In addition, nonpharmacological methods are relatively inexpensive to organizations. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.