BACKGROUND: Esophagogastroduodenoscopy is a very important method to detect gastroduodenal lesions. But the investigation might be delayed due to its own discomfort and anxiety. This study was performed to evaluate the effect of relaxation music on relief of anxiety and physical discomfort during unsedated esophagogastroduodenoscopy. METHODS: From March 3 to May 14 2009, 104 clients who have undergone unsedated esophagogastroduodenoscopy more than once in the past were enrolled in this study. The subjects were randomly assigned to receive either relaxation music (music, N = 52) or no music (control, N = 52) before esophagogastroduodenoscopy. The subjects recorded their anxiety and physical discomfort about latest and today endoscopy by visual analogue scale (VAS). At pre and post music listening, systolic, diastolic blood pressure and heart rate were measured. RESULTS: There was a significant difference of anxiety VAS between music and control group (music, decrease 1.1 +/- 2.1; control, increase 0.0 +/- 1.9; P = 0.008). Throat discomfort VAS was not significant (music, decrease 0.9 +/- 1.8; control, decrease 0.5 +/- 2.7; P = 0.33). Dyspnea VAS decreased in both groups (music, 0.6 +/- 2.2; control, 0.4 +/- 2.5; P = 0.68). Nausea & vomitting VAS also decreased in both group (music, 0.9 +/- 2.2; control, 1.1 +/- 2.1, P = 0.71). There were no significant vital sign changes premusic and postmusic, In both group vital signs increased. Mean differences of systolic pressure(1.0 +/- 11.4 vs. 1.6 +/- 11.1) and diastolic pressure (0.7 +/- 7.3 vs. 1.3 +/- 5.7) were lower in music group, and mean difference of heart rate (1.8 +/- 9.5 vs. 1.5 +/- 8.0) was lower in control group. But There were no significant vital sign changes premusic and postmusic (each P = 0.8, P = 0.62, P = 0.89). CONCLUSION: Listening relaxation music before unsedated esophagogastroduodenoscopy may reduced anxiety.