OBJECTIVES: To compare the effectiveness of music to that of diazepam in reducing preoperative anxiety. PATIENTS AND METHODS: Patients were randomized to 2 groups to receive diazepam or listen to music on the day of surgery and the previous day. Just before the operation, anxiety was assessed with the State-Trait Anxiety Inventory. Cortisol levels, heart rate, and blood pressure were also recorded. RESULTS: Two hundred seven patients were enrolled. No significant differences in any of the outcome measures (anxiety, cortisol level, heart rate, or blood pressure) were found between the 2 groups (music vs sedative). CONCLUSIONS: Our findings indicate that music is as effective as sedatives for reducing preoperative anxiety.