Objective: Pain symptoms are common among adults aged 65 and older, but prevalence rates have not been updated to reflect current national data. We assess prevalence among U.S. adults aged 65 and older with respect to pain (joint, lower back, neck, severe headaches or migraines) and describe symptoms by gender, obesity, and arthritis status. Methods: Analysis of nationally representative data collected from adults aged 65 and older (n = 3810) participating in the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Results: Joint pain and lower back pain are the most frequently reported type of pain, affecting 55% and 38% of elders, respectively. Women are significantly more likely than men to report joint pain, 59% vs. 49%, lower back pain, 42% vs. 33%, and severe headaches, 12% vs. 6% (p <0.0001 for all pain differences). Knee joint pain is significantly higher in women than men (34% vs. 26%), as is finger joint pain (24% vs. 16%). Obese older adults have a higher prevalence than non-obese elders of knee pain (41% vs. 26%) and shoulder pain (21% vs. 16%). Elders with arthritis are about three times more likely than elders without arthritis to have joint pain of the knee (45% vs.14%), finger (32% vs. 9%), shoulder (26% vs. 8%), and ankle (20% vs. 8%). Conclusion: Pain symptoms are highly prevalent among older adults, particularly older women. Joint pain disproportionately affects obese and arthritic older adults. These findings call for increased recognition among providers and targeted interventions promoting symptom management and weight reduction.