BACKGROUND: Dream Doctors (DDs; professional medical clowns) are expanding their activities in pediatric wards. DDs were introduced as an alternative to sedation among children undergoing kidney imaging after urinary infection. The imaging requires that the patient lie completely still under the camera during the scan; otherwise the image cannot be interpreted. It is extremely difficult to get these children to cooperate, and pediatricians have to provide sedation to get good results. Giving sedation requires medical observation, and it can take hours until the child can be safely released from the hospital. METHODS: A DD intervention was introduced in an attempt to avoid sedation in these young children. The DD tried to gain the child’s cooperation during the procedure. Each study was subsequently scored by a radionuclide physician to assess study quality and interpretation. RESULTS: A total of 142 patients were studied over a 14-month period. The mean age was 2 +/- 1.6 years. During the study, in the presence of the DD, only five (3.2%) patients required pharmacologic sedation compared with 100% before the study. CONCLUSIONS: The introduction of DDs proved to be a good alternative to sedation in cases where the procedure does not involve pain and only requires the child’s cooperation.