The objective of this systematic review was to determine the level of scientific evidence for the effectiveness of VR for pain management in adults with pain. A comprehensive systematic search involving major health care databases was undertaken to identify randomized clinical trials (RCTs) and descriptive studies. Twenty-seven studies were identified that fulfilled the inclusion criteria. There was strong (Level 1a) evidence of a greater benefit from immersive VR and limited evidence (Level 2a) for the effectiveness of non-immersive VR in reducing acute pain. Moreover, there is limited evidence (Level 2a) of effectiveness of immersive VR compared to no VR for reducing chronic pain. There is currently no published study that has explored the effectiveness of non-immersive VR for chronic pain (level 5). It is concluded that VR can be recommended as a standard or adjunct clinical intervention for pain management at least in the management of acute pain.