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Aim: This study was conducted to determine the effects of music therapy on non‐stress test results and anxiety levels in high‐risk pregnant women. Methods: This randomized controlled study was conducted in pregnant women who were hospitalized in the High‐Risk Pregnancy Service of Meram Medical Faculty Hospital, Konya, Turkey, between April 1 and July 31, 2021. In the intervention group (n = 58), a 20‐min music therapy with ney sounds was performed, while in the control group (n = 58), routine care practices were applied. Hüseyni maqam of ney was selected, a melodic mode used by Turks for music therapy. Data were collected using the Descriptive Information Form, the Non‐Stress Test Evaluation Form, and the State–Trait Anxiety Inventory. Results: After music therapy, the intervention group experienced increased mean acceleration (p = 0.010) and foetal movement rates (p < 0.001) while no such difference was observed in the control group. The state anxiety levels of pregnant women differed significantly between the intervention and control groups (p < 0.001). Regression analysis showed that music therapy reduced state anxiety levels in pregnant women by a factor of 4.6 (p < 0.001). Conclusion: Based on the findings, music therapy was found to enhance acceleration and foetal heart rate in high‐risk pregnant women while reducing state anxiety levels. Summary statement: What is already known about this topic? Music therapy is a non‐invasive easy application that is frequently used in the treatment of psychological disorders. What this paper adds? Music therapy reduces the state anxiety levels of high‐risk pregnant women.Music therapy can lead to increase in the number of accelerations in high‐risk pregnant women.Music therapy can lead to increase in the number of foetal movements in high‐risk pregnant women. The implications of this paper: Nurses and other healthcare professionals may routinely apply music therapy during the non‐stress test procedure in high‐risk pregnancy services. [ABSTRACT FROM AUTHOR]