Purpose: This study was applied to evaluate the effect of birth ball use on birth satisfaction and pain levels of pregnant women during labor. Methods: The type of study is randomized controlled. The data of the study were collected in the delivery room of a state hospital in Konya/Türkiye between March 2020 and December 2021. The sample of the study consisted of 57 pregnant women for the intervention group and 54 pregnant women for the control group. During labor, intervention group was seated on the birth ball in an upright position; control group was laid on the bed in semi-fawler or lateral positions. In the study, Descriptive Information Form, Birth Process Follow-up Form, Visual Analog Scale and Birth Satisfaction Scale-Revised were used as data collection tools. Results: It was determined that the pain scores of the pregnant women in the intervention group were lower during the first and second follow-up than the control group. The duration of the active phase of labor in the intervention group was shorter than in the control group, and a statistically significant difference was found between them. It was found that the Birth Satisfaction Scale-Revised total score, the sub-dimensions of quality of care, women’s attributes and stress experienced during labor of the pregnant women in the intervention group were higher than the control group. Conclusion: According to the results of the study, the use of a birth ball during the active phase of labor reduces the pain level during labor and increases the level of birth satisfaction of pregnant women.