Children undergoing hemodialysis are repeatedly exposed to pain from approximately 300 punctures per year to their AVF. Pain management are considered as the nursing priority and one of the important aspects of clinical nursing. Cryotherapy is one of the cutaneous stimulation methods. It has an important place among non-pharmaceutical treatments for pain control .Therefore, this study aimed to investigate effect of cryotherapy on pain intensity at puncture sites of arteriovenous fistula among children undergoing hemodialysis. Study settings: This study was conducted at pediatric hemodailysis unit affiliated to Pediatric Nephrology Department at Benha University Hospital . The study sample: Study subjects was consist of all available children undergoing hemodialysis therapy through their arteriovenous fistula over 6 months period in the previously mentioned setting. The children number were 40 children. Tools of data collection: Included a structured interviewing questionnaire , subjective pain rating scale, objective pain scale & numerical pain rating scale. The results: The present study revealed that, The mean of pain score during AVF puncture reduced in the studied children post cryotherapy than pre cryotheray. The study concluded that: cryotherapy was effective on diminishing pain intensity at puncture sites of arteriovenous fistula among children undergoing hemodialysis. The study recommended that, Hemodialysis units can apply cryotherapy technique to reduce AVF puncture pain among children underoing hemodialysis .