Pain management in the critically ill is a challenge and a problem of great concern for critical care nurses. The authors review research on pain in the areas of pain assessment, nurses' knowledge and attitudes, pharmacologie interventions, and nonpharmacologic interventions for the management of pain. Although the research base is not completely developed in the critically ill population, implications for practice arc provided, based upon the findings in populations akin to the critically ill. Strategies arc outlined for achieving improved pain control in critical care units through education, adoption of standards on pain management, and quality improvement activities