Background and aim: preterm infants are exposed to various stressful practices in NICU such as recurrent aggressive and painful procedures, excessive sensory stimulation such as extreme light and sound, improper sleep patterns, and improper handling. Using crochet octopus might enhance preterm physiological parameters and comfort level. The aim of the study was to evaluate the effect of crochet octopus on physiological parameters and comfort level among preterm infants. Design: Quasi quasi-experimental pretest-posttest design was utilized. Sample: A Purposive sample of 30 preterm infants participated in the study. Data were collected through a socio-demographic data sheet, physiological parameters assessment, and comfort scale. Setting: the study was conducted in the NICU at Elmonira University Pediatric Hospital. Results: There were statistically significant differences in the mean score of respiratory rate between before using octopus, 6 hours after using, and before and one day after (P = 0.024 & 0.016, respectively). There were statistically significant differences in the mean score of heart rate between before using the crochet octopus and 6 hours after use and also before and one day after (P = 0.044*& 0.027, respectively). There were statistically significant differences in the total mean score of the comfort scale between before using the crochet octopus, 6 hours after use, and before and one day after (P = 0.041 & 0.023, respectively). Conclusion: The use of crochet octopus enhanced the physiological parameters of preterm infants as well; it improved their comfort score level. Recommendations: Nurses in the NICU could use the crochet octopus as an adjuvant strategy and integrate it into clinical practice while caring for preterm infants.