The main aim of the of the study was to assess the  effectiveness of picture book on level of anxiety and post- operative quality of recovery among children undergoing surgery in selected hospitals, Chennai. Quasi experimental pre-test and post-test design was adopted for this study. Using Non probability purposive sampling technique, 50 children for study group and 50 children for control group were allotted. Data collection was done for the period of one month. Picture book was provided after assessing the demographic variables and pre test level of anxiety before undergoing surgery. The anxiety level after surgery and the post operative quality of recovery was assessed post operatively. The comparison of  pre test level of anxiety and post test level of anxiety among study shows t value of 19.656 and p= 0.001 which is statistically significant. The comparison of post lest level of post operative quality if recovery among children undergoing surgery in study and control group shows t value of 15.97 which is statistically significant at p=0.001 level.