Liu Weiran,1,* Zhang Lei,2,* Stephanie Mu-Lian Woo,3,* Tang Anliu,4,* Xie Shumin,4,* Zhang Jing,5,* Zhang Kai,6,* Zhang Zhen7 1Department of Anesthesia, 2Department of Thoracic Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China; 3Harvard University, Cambridge, MA, USA; 4Xiangya Medical School of Central South University, Changsha, People's Republic of China; 5Tianjin Medical University, Tianjin, People's Republic of China; 6Department of Cerebral Surgery, Tumor Hospital Xiangya School of Medicine, Central South University, Changsha, People's Republic of China; 7Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, People's Republic of China *These authors contributed equally to this work Background: This study aims to analyze the current status of postoperative pain management in the People's Republic of China's provincial-level hospitals, and the existing knowledge and opinions held by patients regarding these methods. Methods: The 128 participants in this study were urology and hepatobiliary patients from three provincial-level hospitals in Hunan. The questionnaire assessing postoperative pain was designed using the typical pain assessment scales and pain management guidelines as references. Results: 82.8% of study participants claimed that their postoperative pain was relieved within 3 days of their operations. However, while 91.4% of surveyed patients experienced moderate to severe pain, 51.6% received no treatment for their postoperative pain, and 14.9% complained that medical personnel failed to manage their pain. 20.2% were unsatisfied with their pain management, indicating that treatment did not meet their expectations. Furthermore, participants demonstrated a great misunderstanding of pain and analgesics, as 72.6% of patients were unfamiliar with morphine, 51.6% of patients believed only certain types of pain required management, and 18.5% refused to use morphine. Conclusion: In most Chinese provincial-level hospitals, current postoperative pain management methods are able to alleviate the pain experienced by the majority of patients, though pain assessment and therapy procedures are still not standardized. Furthermore, most patients lack a proper understanding of postoperative pain and analgesics. Therefore, pain management education for doctors and patients and their relatives should be implemented in order to improve the quality of postoperative pain management. Keywords: postoperative pain, pain assessment, pain management, pain recognition, pain education