Background <p>Chronic pain is a worldwide health concern in aging populations, often accompanying chronic diseases. Despite its prevalence, the impact of chronic pain in older adults is frequently underestimated. This study examines the prevalence, characteristics, and impact of chronic pain among older adults with chronic diseases.</p> Methods <p>Cross-sectional data from 160 participants aged over 60 years with chronic diseases were collected, including their sociodemographic details, current pain status, and pain management. Data was analyzed using Fisher’s exact tests, Student’s t-test and multivariable linear regression to examine the relationships between pain interference and multiple variables.</p> Results <p>The prevalence of current chronic pain was 63.75%, with 69.61% experiencing nociceptive pain. Half of the participants had not received assessment and diagnosis of the chronic pain from health care professionals. Significant associations were observed between perceived pain interference and age (Coefficient = 0.42; 95% CI: 0.07–0.76; p 0.017), maximum pain severity (Coefficient = 1.81; 95% CI: 0.86–2.76; <i>p</i> &lt; 0.001), and pain frequency (Coefficient = 0.22; 95% CI: 0.04–0.39; p 0.015). Common pain management approaches included consultation of healthcare practitioners (40.20%) and alternative medicine (33.33%), with participants reporting high pain interference being more likely to seek practitioner care (58.33%) compared to those with low interference (24.07%, <i>p</i> = 0.001).</p> Conclusion <p>The high prevalence of chronic pain and pain underestimation in older adults underscores the necessity for comprehensive pain management strategies adopting a patient-centered medicine approach. The provision of education to both physicians and patients on appropriate chronic pain management strategies and options may benefit older adults with chronic diseases.</p>