Abstract Background: Shoulder pain and anxiety are common in women undergoing gynecological laparoscopic operations, the effects of virtual reality treatment and effleurage massage on managing these issues and patient satisfaction remain underexplored. Aim: Assess the effect of virtual reality (VR) versus effleurage massage on shoulder pain, anxiety, and satisfaction in women undergoing gynecological laparoscopic operations. Design: A quasi-experimental design was adopted. Sample: 80 women undergoing for gynecological laparoscopic operations, equally divided into a VR group (40) and an effleurage massage group (40) were recruiting. Setting: This study was conducted at the Menoufia University Hospital, Obstetrics and Gynecology Department. Tools: Four tools were used.1) Structured interviewing questionnaire; 2) Visual Analog Scale; 3) Anxiety Rating Scale; 4) Modified Maternal Satisfaction Questionnaire. Results: there was a notable reduction in pain for the massage group with mean pain score for women in the massage group after the intervention was 2.30 ± 3.85, while in the VR group, was 4.40 ± 2.33, A highly significant difference was observed p≤.0.001. The massage therapy group showed better improvement experienced a decrease in anxiety levels compared to the VR treatment group. Women experienced greater satisfaction in the massage group achieving an average score of 10.5 points whereas women in the VR group scored only 8.45 points. Conclusion: Effleurage massage was more effective regarding pain relief, anxiety reduction, and higher women's satisfaction compared to VR for women undergoing gynecological laparoscopic operation. Recommendation: Effleurage massage and VR should be integrated in nursing management for shoulder pain, and anxiety reduction post-gynecological laparoscopic operations.