Aims: The purpose of the current study is to examine paediatric nurses' perceptions of the use of non-pharmacological pain management methods in controlling paediatric procedural pain in various Saudi health sectors in Riyadh City. Background: Pain can be experienced by everyone at some point of their lives. It is the main reason children require health care, and it is one of the main causes of children seeking hospital care services. Pain assessment and management is one of the most important parts of the paediatric nurses' responsibilities towards patients with pain. However, this might be highly influenced by nurses' level of knowledge, attitudes and perceptions about pain. Design and methods: An explanatory sequential design was applied in this study; qualitative methods were utilised to explain the initial quantitative findings (Creswell et al., 2003). A simple random sampling recruited 181 paediatric nurses from various children's departments for the survey. Twelve managers with experience in paediatric nursing and health care were selected purposively for individual interviews. Results: older nurses (51-60 years old), nurses holding a diploma and staff nurses working in the governmental hospital are more likely to apply non-pharmacological methods. Staff nurses 1 and paediatric nurses working in ER are less likely to apply those methods. Paediatric nurses face some barriers that prevent them from applying non-pharmacological methods. Barriers include organizational and relational barriers and issues associated with nurses' autonomy. Conclusion: Hospital types and some paediatric nurses characteristics such as level of education, age, nursing position and nursing field are significant factors when it comes to pain management in children. Organizational factors, relational factors and nurses' autonomy are important factors that either promote or hinder paediatric nurses' use of non-pharmacological pain management.