There are characteristics of children’s medical pain that makes it amenable to intervention. Specifically, almost all procedural events are planned and the steps of the procedure are scripted. Thus, the parent and patient have the ability to be well prepared to handle the stressor. In fact, the medical situation could even be viewed as a valuable opportunity for the family to learn and practice coping skills, which in turn can result in a heightened sense of mastery and empowerment for future expected and unexpected pain and suffering in life. The preparation literature is sufficiently strong to allow recommendations regarding how to prepare children, when to prepare children, and what individual characteristics to consider when preparing children for upcoming painful procedures. Unfortunately, there are considerable obstacles that are preventing this important advice from being put into practice. To take the next critical step of moving the evidence-based advice into the medical setting, it is vital to identify barriers to this translation and to work at removing or working around them. Below, we consider some of the barriers to implementing pediatric procedural preparation. In addition, we offer potential solutions while recognizing that this is no easy task, for, if it were, the barriers would have long been overcome. That said, solutions are posited in hopes that they might inspire others to think of novel answers to incorporating good pediatric preparation science into our medical settings.