Vapocoolant sprays are used in some facilities to manage pain associated with accessing totally implanted venous access devices (TIVADs). They are neither indicated nor contraindicated, and literature supporting safe and effective use within this process is lacking. The purpose of this article is to evaluate the use of vapocoolant sprays within the TIVAD access process and to facilitate best practice accounting for product use and safety, institutional policy, and individual patient needs.