To describe the level of knowledge, attitudes, and self-reported quality of practice in pain assessment among nurses of Mainland China and explore links with current hospital pain policy and continuing education. Background.: Knowledge is necessary for skilled pain assessment among nurses. Little is currently known regarding knowledge, attitude toward, and self reported pain assessment by nurses from Mainland China. Methods.: Quantitative research and cross-sectional convenience sampling assessed nursing knowledge, attitude, and practice among 101 nurses working in high-level hospitals in Mainland China. Results.: 81.2 of nurses participating in the survey were from high-level (level three) hospitals in Mainland China. 24.8 of the nurses attended continuing education in pain assessment. No nurses from the 76 hospital staffs surveyed were able to recall any hospital policy regarding pain assessment. Knowledge regarding pain assessment was rated at 1.9 (SD=1.6) on a (0-7) scale. 27.7 of nurses possessed a positive attitude toward pain assessment. Pain assessment was not routine in most of the hospitals surveyed. Nurses who attended continuing education showed greater knowledge and more positive attitudes regarding pain assessment but did not show improvement in their quality of practice. Conclusions.: This study identified inadequate knowledge and low level of self-reported pain assessment practice among nurses working in high-level hospitals in Mainland China. Current education did not influence nursing self-reported pain assessment practice. Knowledge of pain evaluation should be improved through newer approaches to education. A better policy framework for pain evaluation may also contribute to improvement. ? 2013 American Academy of Pain Medicine 14 10 October 2013 10.1111/pme.12156 ORIGINAL RESEARCH ARTICLES ORIGINAL RESEARCH ARTICLE Wiley Periodicals, Inc.