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Abstract : It is a widely used anesthetic drug for induction and short-term anesthesia, one of the side effects of this drug is pain during injection. This pain is caused by the connection of the phenol ring to the nerve endings in the endothelium of the veins, which causes discomfort for patients. This issue has led to the selection of different materials and methods to reduce pain during propofol injection. The aim of this study was to evaluate the effect of adding fentanyl to Valsalva maneuver in reducing pain caused by propofol injection. Our study was a three-way randomized blind clinical trial in which 120 patients who were candidates for propofol anesthesia were divided into two groups. Patients in the first group were injected with 100 g of fentanyl and patients in the second group were injected with normal saline. Two minutes later, propofol was injected in a dose of 0.2 mg / kg for both groups. The amount of pain during their injection is measured using the VAS criterion. The collected data were analyzed using SPSS software version 23 and one-way analysis of variance, repeated measures analysis of variance, Kruskal-Wallis independent t-test, Friedman and Wilcoxon. Heart Rate, Mean Arterial Pressure, systolic and diastolic Blood Pressure were higher in group that receive normal saline and close valve Valsalva manometer than fentanyl and open valve Valsalva manometer(p-value> 0.001). All variables were higher in the tome of injection. Fentanyl is more effective in reducing pain caused by propofol injection compared to Valsalva maneuver. However, Valsalva maneuver is not ineffective.