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AIM: To determine whether listening to music decreases the requirement for dosages of sedative drugs, patientsanxiety, pain and dissatisfaction feelings during colonoscopy and makes the procedure more comfortable and acceptable.METHODS: Patients undergoing elective colonoscopy between October 2005 and February 2006 were randomized into either listening to music (Group 1,n = 30) or not listening to music (Group 2,n = 30).Anxiolytic and analgesic drugs (intravenous midazolam and meperidine) were given according to the patientsdemand. Administered medications were monitored. We determined their levels of anxiety using the State-Trait Anxiety Inventory Test form. Patientssatisfaction, pain,and willingness to undergo a repeated procedure were self-assessed using a visual analog scale.RESULTS: The mean dose of sedative and analgesic drugs used in group 1 (midazolam: 2.1 ± 1.4,meperidine: 18.1 ± 11.7) was smaller than group 2(midazolam: 2.4 ± 1.0, meperidine: 20.6 ± 11.5), but without a significant difference (P ＞0.05). The mean anxiety level in group 1 was lower than group 2 (36.7 ±2.2 vs 251.0 ± 1.9, P ＜0.001). The mean satisfaction score was higher in group 1 compared to group 2 (87.8± 3.1 vs 58.1 ± 3.4, P ＜0.001). The mean pain score in group 1 was lower than group 2 (74.1 ± 4.7 vs 39.0 ± 3.9,P ＜0.001).CONCLUSION: Listening to music during colonoscopy helps reduce the dose of sedative medications, as well as patientsanxiety, pain, dissatisfaction during the procedure. Therefore, we believe that listening to music can play an adjunctive role to sedation in colonoscopy. It is a simple, inexpensive way to improve patientscomfort during the procedure.