OBJECTIVES: The objective of this analysis was to compare anticipated pain prior to surgery with actual pain experienced postoperatively by patients undergoing outpatient surgical arthroscopic knee procedures. METHODS: In a prospective multicenter study, patients undergoing knee arthroscopy reported their anticipated pain prior to surgery. The patients recorded actual pain at the time of discharge and on the evening of surgery, at which time they assessed their worst pain and average pain since the surgery. Pain was measured on a visual analog scale (0 = none to 10 = worst pain). The anticipated pain and actual pain were compared with a paired student t-test. Using the difference in the actual pain and the anticipated pain measure as a dependent variable, three multiple regressions were performed where anticipated pain intensity, age, gender, ethnicity, education, and surgery duration were used as covariates. RESULTS: Forty-two patients enrolled in the study. The mean age was 45.8 years, 54.8% were female, 69% were white, and 37% had a high school education or less. The mean duration of surgery was 28 minutes. The pre-surgery anticipated pain was 6.0 + 2.1 (mean + SD); the actual pain was 2.5 + 2.8, 4.3 + 2.4 and 5.7 + 2.7 for discharge pain, average pain, and worst pain, respectively. The t-tests indicated that discharge pain and average pain were significantly different from anticipated pain (p <0.05). On the contrary, the worst pain was in a close agreement with the anticipated pain. From the multiple regressions, there were no significant covariates except the anticipated pain for the difference between discharge pain or average pain, and anticipated pain, respectively. CONCLUSIONS: Although the worst pain reported may be closest to the anticipated pain reported, there is still a considerable gap in the anticipation of pain, which may create an additional psychological burden on the patients.