Introduction: local anesthesia and computerized anesthesia via infiltrative technique have become a key component for painless dental treatments. This study aimed to evaluate the efficacy of computerized anesthesia compared to local anesthesia applied through the infiltrative method. Method: an electronic search for randomized clinical trials published between 2019 and 2024 was conducted in the Medline, Scopus, and Virtual Health Library databases. The search strategy used was 'Computerized anesthesia OR local anesthesia AND pain AND pediatrics.' A total of 170 articles were found, of which eight randomized clinical trials were analyzed in a qualitative synthesis, and six in a subsequent meta-analysis. Results: the results indicated that computerized anesthesia compared to local anesthesia is more effective in reducing self-perceived pain, presenting a large effect size (SMD: -1,05; 95% CI: -2,01 to -0,08). However, the few studies analyzed together with the high heterogeneity (Tau2= 1.38; Chi2= 120,76, df = 5, p < 0,001; I2 = 96 %) do not allow a complete affirmation of these findings despite that the literature has suggested better acceptance and reduction of fear of dental procedures associated with the use of syringes in the pediatric population. Conclusion: it is suggested that computerized anesthesia is more effective in reducing pain, although it is more expensive and requires more training to achieve an optimal, painless procedure that can reduce phobias associated with dental treatments.