All children undergo needle procedures as part of routine medical care. Numerous interventions are available for relieving pain from needle procedures. These interventions can be divided into four domains (4 Ps of pain management): procedural, pharmacological, psychological, and physical. Treating needle pain reduces pain and distress and improves satisfaction with medical care. Other potential benefits include a reduction in the development of needle fear and subsequent health care avoidance behaviour. Adoption of the 4Ps into routine clinical practice is feasible and should become a standard of care in the delivery of health care for children. This chapter is a narrative review of the current knowledge about: epidemiology, pain experience, practices and attitudes, and evidence-based interventions for pain management during common needle procedures.