Background: Anxiety and pain from insulin injections are frequent side effects. Therefore, controlling injection pain aids in reducing anxiety and subsequent health care avoidance behaviors. Foot reflexology massage appears to be useful in decreasing pain and stress as a complementary care that is becoming widely accepted and popular. Aim: This study aimed to evaluate the effect of foot reflexology massage on pain and anxiety levels regarding insulin injection among diabetic children. Design: A quasi-experimental research design was used to conduct this study. Setting: The study was carried out at Pediatric Endocrine Department at Mansoura University Hospital Subjects and method: A purposive sample of 100 diabetic children who receiving insulin injection were recruited in this study; the studied children were assigned into two groups, with 50 children in each group (the study and control groups).  Tools: Three tools were used to collect data: Tool (1): A structured interviewing questionnaire. Tool (II): Numeric Pain Rating Scale (NPRS), and Tool (III): State-Trait Anxiety Inventory for Children (STAIC). Results: The present study revealed that more than half of diabetic children in the study group had mild pain compared to only (8%) in the control group after insulin injection. Moreover, there were  highly statistical significant differences post foot reflexology massage among the studied diabetic children regarding anxiety level on STAIC between the study and control groups. Conclusion: Foot reflexology massage has an effect on pain and anxiety reduction regarding insulin injection among diabetic children. Recommendation: Foot reflexology massage could be applied as a non-pharmacological method and complementary therapy along with routine care to manage insulin injection pain and anxiety among diabetic children.