Childhood maltreatment, including abuse and neglect, is a widespread global issue, with nearly 400 million children under age 5 experiencing psychological or physical aggression at home. Sexual violence affects millions worldwide, with significant long-term consequences. Maltreatment is the leading preventable cause of psychopathology, accounting for approximately 45% of childhood-onset psychiatric disorders, and it leads to altered brain development. Childhood maltreatment is also linked to chronic pain, affecting 20% of adults globally and 30–40% of the adult US population, contributing to substantial healthcare costs and lost productivity. Pain frequently co-occurs with psychiatric conditions, including mood and anxiety disorders, PTSD, and self-harm thoughts. Emerging research indicates that maltreatment disrupts the endocannabinoid signaling system, which plays a critical role in pain regulation and homeostasis. The endocannabinoid system is also becoming a key target for understanding and treating psychiatric disorders associated with chronic pain. However, the specific mechanisms through which childhood maltreatment impacts pain development and perception remain unclear. Given the global burden of maltreatment and pain, the complex relationship between these factors and the endocannabinoid system warrants further investigation. This chapter reviews the types, prevalence, and predictors of childhood maltreatment, its association with pain, and the role of the endocannabinoid system, offering a conceptual model and clinical implications for future research.