Background: Children frequently exhibit high levels of distress while undergoing routine blood sampling or injections. If the child is not treated with appropriate care, the feelings of distress may increase over time and result in needle-phobia. Objective: The purpose of this study was to describe nurses´ possibilities to relieve distress in children undergoing needle sticks. Method: A systematic literature review was conducted through database search and screening of reference lists. Ten research articles with a quantitative approach were included, coded for quality and then analyzed. Results: Main results were presented in two categories, the effect of preparation and the effect of distraction. To prepare children with information failed to reduce children’s distress, but in combination with application of EMLA the effect could reach significance. The effect of distraction was inconsistent but distress seemed to decrease when nurses interacted in distracting the child. Conclusions: Children´s distress while undergoing needle sticks are affected by many different variables and this study failed to present generalizable ways for nursing care. Nurses are important and have the potential to make a difference in caring for the child. However there is little guidance for nurses on how to relieve children´s distress in recent literature. Future research should focus on nurses´ possibilities through a wider perspective to reach holistic guidance in this matter.