Pain is a common finding in dying patients. Most patients who experience pain at the end of their lives can have their pain effectively treated by their primary care physicians. The key to pain management is good pain assessment and a working familiarity with pain medications. Opioids are particularly important, and primary care physicians should be comfortable in prescribing these medications and should be familiar with appropriate dosing regimens. Clinical and ethical concerns regarding the use of opioids are overestimated, and opioids can be used safely in most pain management situations.