Purpose Clown doctors are a feature in pediatric hospitals, visiting children and families, providing a welcome escape from the reality of hospitalization. Though the use of humor to improve health and wellbeing has been widely researched, limited exploration of the role of clown doctors has occurred. This study aims to elucidate the role of clown doctors within a major pediatric hospital. Methods This was an ethnographic study. Ethnography is an innovative approach to pediatric research, giving an intricate view that is otherwise difficult to attain. Participants for this study included the clown doctors employed at a tertiary pediatric hospital, and every person they had a meaningful encounter with during the course of their work, including: patients, families, clinical and non-clinical staff. Data was collected via participant observation, with approximately 1,500 hours of ‘clown ward rounds’ documented over one year. Interviews and visual methods were utilized, with participants explaining and drawing their experience of the clown doctors. A constructivist framework was used to analyze emergent themes. Results Themes that arose from the data relating to the function of clown doctors included: distraction, anxiety reduction and procedural assistance; entertainment and making people laugh; emotional support and providing comfort; and communication, including translating clinical information to families. These functional elements of the clown doctors are the result of a more complex, intimate human connection that arose due to the nature of the clown being low-status, open, and vulnerable, and in particular existing as an outsider within the medical establishment. These interconnected relationships drove engagement and resulted in clown doctors becoming privy to information, emotions, complaints, jokes, disclosures etc., often not revealed by patients and their families to staff members, or even vice versa. Building relationships is key to the clown doctors. They do so with every person they interact with: in wards and waiting rooms, clinics, corridors, and following surgery. These relationships can be transient or long-term, deep or superficial, but all of them are developed from a place of sincerity. Clown doctors interact with the person rather than a disease or illness. Conclusion While almost universally acknowledged as a positive addition to the hospital, most people who encounter the clown doctors have little conception about the scope of their role. Although clown doctors are often described in concrete clinical terms, their real power lies in their ability to connect with people, and the psychosocial advantages that connection provides. The results of this descriptive study provide valuable insight and a comprehensive understanding of clown doctors and the complexity of human relationships within a major pediatric hospital, uncovering a profound, nuanced culture cheerfully highlighting the need for a more person-centered approach to healthcare.