Background: Venipuncture is the most frequent unpleasant invasive technique that is typically performed on children. This process makes children anxious and afraid. So, this study aimed to investigate the effects of leg crossing and hand gripping techniques on fear and physiological measures of children during vein puncture. Research design: A quasi-experimental design was utilized in this study. Setting: This study was carried out in the pediatric intermediate care unit at Assiut university children hospital. Sample: Included a purposive sample of 60 school age children were selected. They were assigned randomly into two equal groups: Leg crossing, hand gripping group and control group. Tools of data collection: Three tools were used Tool I: A structured interviewing questionnaire to assess personal, medical data of studied children, and factors affecting children' fear. Tool II: Physiological measurements of children to measure vital signs and oxygen saturation. Tool III: Children's fear scale. Results: showed that there was a highly statistically significant difference between two groups regarding fear level p=<0.01 and physiological measurement p < 0.05. Conclusion: Hand gripping and leg crossing techniques were effective for reducing fear level and maintaining stable physiological measures during vein puncture. Therefore, it is Recommended that the use of leg crossing, and hand gripping techniques should be integrated as a part of routine daily care for children during vein puncture.