It has been almost 30 years since the advent of functional magnetic resonance imaging (fMRI) to study human brain function noninvasively. This chapter provides a high-level overview of the technical advances in pain neuroimaging and the mechanistic insights gleaned. From FMRI investigations of the human brain in pain conditions, which have studied thousands of people in pain. We discuss advances in understanding the physiological basis of evoked pain, the pathophysiological basis of chronic pain, and the opportunities that fMRI provides to diagnose, manage, and treat pain. We also briefly speculate on the additional advances necessary to advance the field.