Pain management is a critical component of care in the intensive care unit (ICU). Critically ill patients often experience pain from various sources, including surgical procedures, trauma, mechanical ventilation, and invasive monitoring devices. Uncontrolled pain can lead to adverse outcomes such as increased stress responses, hemodynamic instability, impaired wound healing, prolonged mechanical ventilation, and the development of chronic pain syndromes. This chapter outlines a systematic approach to pain assessment and management in the ICU, emphasizing the use of appropriate assessment tools, differentiation of pain types, and implementation of multimodal analgesia strategies to optimize patient comfort while minimizing opioid-related side effects [1] (Ref. Algorithm 14.1).