Purpose <p>The purpose of the study was to evaluate and compare the effects of custom-made camouflaged caterpillar, camouflaged alligator and conventional syringes on anxiety and behaviour in children during local anaesthesia administration.</p> Methods <p>This was a randomised controlled study in which 150 children aged between 7 and 9&#xa0;years were randomly assigned to receive local anaesthesia using a custom-made camouflaged caterpillar, a camouflaged alligator or a conventional syringe. A pulse oximeter was used to measure pulse rate. Children were scored using the Venham’s Clinical Anxiety Scale (VCAS) and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale. Data were analysed using repeated measures ANOVA, one-way ANOVA followed by Tukey’s honestly significant difference (HSD) post-hoc test, and chi-square tests. After the treatment, the child was asked to fill out the Venham’s Picture Test (VPT). In addition, parents were asked to fill out the Parental Emotional Stress Questionnaire (PESQ) and recall questionnaire.</p> Results <p>The mean increase in the pulse rate was lowest in the custom-made caterpillar camouflaged syringe group, with a statistically significant difference. The mean scores of VCAS (0.66 ± 0.69), FLACC (1.38 ± 1.05), and VPT (0.62 ± 0.75) were lowest in the custom-made caterpillar camouflaged syringe group, which signified better behaviour of a child than the other two groups. The parental emotional stress quotient in the custom-made caterpillar camouflaged group revealed satisfactory outcomes with the procedure.</p> Conclusion <p>Custom-made caterpillar camouflaged syringes for local anaesthesia effectively decreased the anxiety of children.</p>