Autism spectrum disorder (ASD) prevalence has risen dramatically in recent decades; it is now common for children with ASD to seek dental care. Because their distinct behavioral patterns prevent them from receiving dental care in a traditional dental clinic, structured dental visual aids are required to help prepare them for their dental appointment. This study aimed to test the effect of “culturally adapted dental visual aids” in decreasing anxiety levels during dental visits in children with autism spectrum disorder (ASD). A randomized, controlled, blinded clinical trial was performed. Sixty-four children with ASD ages 6–12 years were assigned randomly into test and control groups based on the type of dental visual aids they received. The test group received “culturally adapted dental visual aids” created especially for the study, and the control group received “regular dental visual aids”. Anxiety levels were assessed before and after using both dental visual aids. All data were processed using SPSS version 25.0. The test group had a significant decrease in anxiety levels compared to the control group (p< 0.001). The “culturally adapted dental visual aids” have effectively reduced anxiety levels in children with ASD during dental visits.