The purpose of this investigation was to evaluate the effects of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures. Forty-four adults scheduled for head and neck procedures were randomly assigned into 2 groups for this single-blind investigation. Anxiety and baseline pain levels were documented preoperatively. Both groups received 28 minutes of privacy, during which subjects in the experimental group listened to a guided imagery compact disk (CD), but control group patients received no intervention. Data were collected on pain and narcotic consumption at 1- and 2-hour postoperative intervals. In addition, discharge times from the postoperative anesthesia care unit (PACU) and the ambulatory procedure unit and patient satisfaction scores were collected. The change in anxiety levels decreased significantly in the guided imagery group (P = .002). At 2 hours, the guided imagery group reported significantly less pain (P = .041). In addition, length of stay in PACU in the guided imagery group was an average of 9 minutes less than in the control group (P = .055). The use of guided imagery in the ambulatory surgery setting can significantly reduce preoperative anxiety, which can result in less postoperative pain and earlier PACU discharge times.