Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 05 23 1499 1499 Masoud Kashefizadeh Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Yousef Asadoola Jamshidi Department of Adult Nursing, College of Nursing, University of Kut, Wasit, Iraq. Maryam Kazempour Department of Paediatric Dentistry, School of Dentistry, Ilam University of Medical Sciences, Ilam, Iran. 2025 11 22 2025 12 01 Background: Before dental procedures, children often require mild to moderate sedation. This study was conducted to determine the effect of rectal midazolam on pediatric dental pain using a systematic review method. Methods: In this systematic review study, articles published from 2000 up to the beginning of 2025 that focused on the effect of rectal midazolam on the clinical condition of pediatric patients undergoing dental services were included. The search was conducted by both authors of the article: one holding a specialization degree in pediatric dentistry and the other being a pharmacist. The search keywords included "pediatrics," "tooth," "dentistry," "dental services," "midazolam," "rectal midazolam," "children," and "clinical indicators." The search was performed across all international databases, including PubMed, Scopus, Web of Science, Embase, EBSCO, and the Google Scholar search engine. After searching for the articles, the relevant data were extracted using a checklist designed by the researchers, and the findings were reported in table format using a descriptive method. Results: The result showed the initial search yielded 189 articles. After reviewing and evaluating the articles based on research objectives, methodology, the type of drug prescribed to patients, the method of drug administration, the manner of reporting findings, the language of publication, and the availability of the full article files, 5 articles proceeded to the systematic review stage. Also, in all extracted studies, the administration of rectal midazolam resulted in a positive effect on the clinical conditions of the patients, and the administration of this drug caused no side effects in the patients. Conclusion: The administration of midazolam rectally has proven effective in achieving the study objectives, including maintaining stable clinical conditions for the patients and resulting in no significant clinical side effects. Therefore, the rectal administration of this drug is recommended. https://aacc.tums.ac.ir/index.php/aacc/article/view/1499