Purpose <p>We aim to evaluate the patient-anticipated degree of pain versus the experienced degree of pain before and after cystoscopy in patients undergoing their first outpatient cystoscopy.</p> Methods <p>We studied 39 patients who underwent their first office-based cystoscopy. All cystoscopies were performed with the disposable Ambu aScope 4. Anticipated cystoscopy-associated pain was judged with a pre-procedural score, and pain experienced during the cystoscopy was judged with a post-procedural score. All patients graded their pre- and post-cystoscopy pain using a standard 10-point scale (0–10).</p> Results <p>Medians and interquartile ranges the patients’ age [65 years (54.5–68.0)], pre-procedural pain [7 (5–8)], and post-procedural pain [2 (1–3)] were recorded. Thirty (77%) patients were male and nine patients (23%) were female. The average pre-procedural prediction pain score was 6.56 ± 2.18; the average post-procedural perceived pain score was 2.36 ± 1.72 (<i>P</i> &lt; 0.05). There was an average decrease of over 4 points in predicted pain vs. perceived pain. There was no significant difference observed between expected (<i>p</i> = 0.84) or experienced (<i>p</i> = 0.59) pain scores between male and female patients. There was also no observed difference based on age, when comparing patients 65 and younger to those older than 65 years of age (expected <i>p</i> = 0.18, experienced <i>p</i> = 0.19).</p> Conclusion <p>Patients experience significantly less pain with outpatient cystoscopy than they anticipate having. This study will be helpful when counseling patients about the use of cystoscopy to evaluate urologic pathologies.</p>