The purpose of this study was to describe nurses' perceptions of their practices in the assessment and management of pain in children. Questionnaires were distributed to 260 nurses in a pediatric hospital in the western United States. Results showed that nurses are not consistently assessing pain in children, and pain management practices are not based on systematic assessment. The most frequently reported tool for assessing pain was the numeric rating scale. Children experience a variety of painful procedures during hospitalization, but nurses reported that they are not consistently administering analgesics for painful procedures. Although rarely used, distraction and relaxation techniques were the most frequently reported nonpharmacological interventions. Although nurses did not feel that there were factors preventing them from assessing or managing pain in children, their practices revealed both that they are not using developmentally appropriate tools for assessing pain, and they have not maximized the use of management strategies for controlling pain.