The chapter discusses the importance of pain assessment in spinal surgery, focusing on various aspects of pain such as intensity, disability, duration, and affect. Different instruments for pain assessment, including Visual Analogue Scale (VAS), Graphic Rating Scale (GRS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and Pain Drawing, are evaluated in terms of their advantages and disadvantages. The chapter also highlights the role of psychological and psychosocial factors in pain perception and the impact of coping strategies, pain acceptance, pain tolerance, and pain-related anxiety on surgical outcomes. It concludes with recommendations for a minimum and more comprehensive pain assessment, emphasizing the integration of pain intensity, affect, and disability.The chapter discusses the importance of pain assessment in spinal surgery, focusing on various aspects of pain such as intensity, disability, duration, and affect. Different instruments for pain assessment, including Visual Analogue Scale (VAS), Graphic Rating Scale (GRS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and Pain Drawing, are evaluated in terms of their advantages and disadvantages. The chapter also highlights the role of psychological and psychosocial factors in pain perception and the impact of coping strategies, pain acceptance, pain tolerance, and pain-related anxiety on surgical outcomes. It concludes with recommendations for a minimum and more comprehensive pain assessment, emphasizing the integration of pain intensity, affect, and disability.