Virtual Reality (VR) has been frequently used as an engaging, interactive, and effective non-pharmacological distraction technique for children during painful procedures, including burnt wound care. This study aimed to evaluate the effect of virtual reality on pain and clinical outcomes during hydrotherapy for children with burns. A randomized controlled pretest, during, and post-test research design was utilized. Sixty children with burns underwent hydrotherapy, divided randomly and assigned equally into two groups. Children of the control group received the standard pharmacological treatment of the unit to manage pain and stabilize their physiological parameters throughout the three days of study. Children of the virtual reality intervention group received all basic standard care as the control group plus VR intervention across different software content, and interaction immersion designs which took place using a cell phone coupled with the three-dimensional (3D) image glasses. Outcome measures were physiological parameters, wound healing, and Face, Leg, Activity, Cry and Consolability (FLACC) Behavioral Pain Assessment Scale. This study was carried out in the burns unit at the Plastic, Reconstructive, and Burns Surgery Center affiliated to Mansoura University, from September to November 2023. Children in the study group had lower pain scores, more stable physiological parameters, and higher rates of wound healing compared to the control group with a statistically significant difference between both groups. Using VR intervention significantly reduced pain intensity, enhanced physiological parameters and promoted the rate of wound healing in children with burns during hydrotherapy. [ABSTRACT FROM AUTHOR]