The data related to pain and catastrophic health expenditure (CHE) needed to be further explored. This study aims to understand the relationship between pain and CHE. Using cross-sectional analysis of 4-year data (2015-2018) from the Korea Health Panel, the prevalence of CHE and adjusted odds ratio (AOR) by pain type were confirmed. Among participants (n = 46,597), the prevalence of pain and severe pain were 24.2% and 1.1%, respectively. The use of medical services in emergency rooms, hospitalizations, and outpatients increased in the order of pain-free, pain, and severe pain (P < 0.001). Prevalence of household CHE was 3.3% vs. 11.1% vs. 25.9%, (P < 0.001). The AOR of CHE was 1.5 (95% confidence interval [CI], 1.4-1.7) for pain and 3.1 (95% CI, 2.5-3.9) for severe pain. Household capacity to pay per year was lower and lower in the order of pain-free, pain, and severe pain ($25,094 vs. $17,965 vs. $14,056, P < 0.001). Also, the household out-of-pocket expenditure per year was higher and higher in the order of pain-free, pain, and severe pain ($1,649, $1,870, $2,331, P < 0.001). It can be inferred that pain is one of the mechanisms of poverty. Positivist healthcare policies for the prevention and management of pain should be sought.