There is a controversy on whether listening to music before or during colonoscopy reduces anxiety and pain and improves satisfaction and compliance with the procedure. This study aimed to establish whether specifically designed music significantly affects anxiety, pain, and experience associated with colonoscopy. In this semirandomized controlled study, 34 patients undergoing a colonoscopy were provided with either muted headphones (n=17) or headphones playing the investigator-selected music (n=17) for 10 minutes before and during colonoscopy. Anxiety, pain, sedation dose, and overall experience were measured using quantitative measures and scales. Participants' state anxiety decreased over time (P <.001). However, music did not significantly reduce anxiety (P=.441), pain scores (P=.313), or midazolam (P=.327) or fentanyl doses (P=.295). Despite these fi ndings, 100% of the music group indicated that they would want music if they were to repeat the procedure, as compared with only 50% of those in the nonmusic group wanting to wear muted headphones. Although no significant effects of music on pain, anxiety, and sedation were found, a clear preference for music was expressed, therefore warranting further research on this subject.