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Background and Aims Localized neuropathic pain represents a chronic and debilitating clinical condition. The application of 8% capsaicin patches for 60 minutes has been established as an effective therapeutic option; however, adverse events experienced during the application period frequently hinder patient adherence to the full duration of treatment. In response to this challenge, the Pain Unit at Getafe University Hospital aimed to evaluate the effectiveness of virtual reality (VR) headsets as a distraction tool to enhance patient tolerance during capsaicin patch administrationMethods A prospective, observational, and experimental study was conducted involving 22 adult patients diagnosed with localized neuropathic pain. Participants were randomly assigned to one of two groups: the experimental group (capsaicin patch + VR headset) and the control group (capsaicin patch alone). Treatment tolerance was defined by the patient‘s ability to complete the full duration of capsaicin patch application. Pain intensity was measured using the Visual Analogue Scale (VAS), and patient satisfaction was assessed through the EMCA questionnaire. Data collection was performed using self-administered and anonymized questionnaires.Results A statistically significant difference in treatment tolerance was observed between the experimental group (69.2%) and the control group (30.8%) (p = 0.030). Additionally, the mean pain score reported by patients in the experimental group (3.91 ± 2.77) was significantly lower than that reported in the control group6.34 ± 2.30) (p = 0.029). In contrast, no significant differences were found in satisfaction levels between groups (p = 0.164), with median scores of 10 (interquartile range: 8.50–10) in the experimental group and 8 (IQR: 7–10) in the control groupAbstract OP30 Figure 1Use of VR headsets for the treatment of localized neuropatic pain in lower limbAbstract OP30 Figure 2Placement of VR headsets on the patient by the nurseConclusions This study supports the use of virtual reality as a promising, feasible, and safe non-pharmacological intervention to improve patient tolerance during capsaicin patch treatment for localized neuropathic pain.