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Objective: To compare the difference in pain score between the patients who visualized their flexible cystoscopy finding on the video monitor and those who did not view the procedure. Materials and Methods: A prospective randomized controlled trial was conducted at Ratchaburi Hospital between December 2017 and February 2018. Forty male patients undergoing flexible cystoscopy were randomized into two groups. Group A patients (n = 20) were allowed to view their procedure real-time on the video monitor. Group B patients (n = 20) were unable to view the video monitor. All patients recorded their pain on a visual analog scale (VAS) ranging from 0 to 10 after completing the procedure. The blood pressure and pulse were also recorded five minutes before the procedure and immediately after the procedure. Results: The pain score on the VAS in group A was statistically significantly lower than that in group B (1.0 (0, 2.0) vs. 3.0 (1.0, 5.0), p=0.004). There was no statistically significant difference in the post-procedure systolic blood pressure and pulse between the two groups. Conclusion: Real-time visualization of flexible cystoscopy finding in male patients made the procedure less painful on the VAS. Therefore, the authors highly recommend this useful technique during flexible cystoscopy. [ABSTRACT FROM AUTHOR]