Objective: The aim of this research was to examine the effect of visual storytelling on externalizing and internalizing behaviors in children with oppositional defiant disorder. Method: This study was quasi-experimental (controlled pretest-posttest with follow-up). The statistical population included primary-school children in Tehran with oppositional defiant disorder. Using purposive sampling, we selected 22 primary-school children diagnosed with oppositional defiant disorder visiting a learning and therapeutic center. Before the intervention, their parents completed the Child Behavior Checklist as a pre-test. In the next step, 13 visual storytelling sessions were held for the experimental group. At the end of the intervention, the parents completed the noted checklist for pre-test and follow-up. Results were analyzed using univariate and multivariate covariance analyses. Results: The results showed that visual storytelling significantly reduced externalizing behaviors on the post-test and follow-up. However, it significantly reduced internalizing behaviors only on the post-test, with no significant change in the follow-up. Conclusion: Visual storytelling can be used as an intervention method to decrease externalizing behaviors in children. Internalizing behaviors can also be reduced in case of an ongoing implementation of this method.