Objective To design and explore application effect of psychological preparation play for preschool children before cranial MRI examination. Methods A total of 220 preschoolers aged 3~6 years who underwent non-sedative cranial MRI examination in the radiology department of a class A children’s hospital in Zhejiang Province from April to July 2021 were selected as participants. Among them，110 children whose parents agreed to participate in the psychological preparation play were enrolled in the experimental group，and 110 children whose parents disagreed to participate were classified into the control group. The first pass rate and anesthesia/sedation rate were compared between the two groups. Results The one-time pass rate of test group of 93.6%（103/110） was higher than that of control group（79.1%，87/110），and the difference was statistically significant（χ²=9.881，P=0.002）. The utilization rate of anesthesia/sedation in the experimental group of 4.5%（5/110） was lower than the demand rate of sedation was lower than that in the control group（20.9%，23/110），and the difference reached statistically significant（χ²=13.259，P<0.001）. Conclusion The application of psychological preparation play before cranial MRI examination can significantly improve the pass rate，and can reduce the use of sedation/anesthesia medications among preschool children.