OBJECTIVES: US national survey data indicates that acute postsurgical pain is inadequately relieved in patients and multiple studies report a high prevalence of moderate to severe pain following surgery. The objective of this study was to examine acute pain outcomes, including hospital length-of-stay (LOS), medications, and pain scores, following orthopedic and abdominal surgery using retrospective data for a large cohort of adult patients. METHODS: Using an electronic health record database with information from 614 hospitals across the US (Cerner Health Facts®), we evaluated trends in pain measurement, treatment, and outcomes associated with acute postsurgical pain management (n=1,581,795 adult patients from 2009-2015). The analysis included orthopedic (ICD9 codes of 76-84.X, 00.7-00.8) and abdominal surgery (ICD9 codes of 42.X-71.X) patients. Patients included in the analysis had to have at least one recorded pain score (0 to 10 scale) before and after surgery. Pain score, hospital LOS, and type of medications received were examined. RESULTS:  Pre and post-operative pain was examined in orthopedic (n=328,893) and abdominal surgery (n=719,428) patients. Mean hospital length-of-stay was similar between the two surgery groups (4.6 and. 4.7 days for abdominal and orthopedic surgery, respectively). Following surgery, 58% of patients undergoing abdominal/pelvic surgery were treated with polytherapy (more than one type of pain medication administered) for pain and 79% of orthopedic surgery patients were treated with polytherapy (vs. monotherapy). 53% of abdominal surgery patients received multimodal therapy (combination of opioid and non-opioid medications), 40% received opioid-only treatment while 7% received non-opioid only therapy. 77% of orthopedic patients received multimodal therapy while 19% received opioid only and 4% received non-opioid only therapy. CONCLUSIONS:  Postsurgical length-of-stay is similar between orthopedic and abdominal surgery patient groups. In orthopedic patients, providers rely more heavily on polytherapy and opioid treatment methods to effectively manage pain.