The importance of hope in determining the adjustment of patients with cancer to their illness has been recognized. Stressful events such as pain and disease metastasis may have an impact on patients’ hope levels. This study had three purposes: 1) to examine the effect of disease status on hope levels among patients with cancer who have pain; (2) to compare the level of hope between patients with cancer who have pain and those do not; and (3) to determine which dimensions of pain are associated with hope. Patients (n = 226) with various cancer diagnoses completed the Herth Hope Index. Disease status was measured by one objective indicator (disease stage) and one subjective indicator (perceived treatment effect). The Perceived Meanings of Cancer Pain Inventory was used to measure the cognitive dimension of pain, whereas pain intensity and relief were used to represent the sensory dimension of pain. The patients’ disease stage did not affect their level of hope, but their perception of treatment effect was associated with this factor. No difference in level of hope was found between patients with pain and those without pain. For those with pain, the cognitive dimension of pain (meaning ascribed to pain) was significantly correlated with hope, whereas sensory dimensions (pain intensity and relief) showed no such correlation. The study results support the role of cognition in promoting the psychological well-being of patients with cancer.