Chronic pain contributes to allostatic load (AL). Individuals with protective psychosocial and biobehavioral factors report lower levels of clinical pain. We have previously shown a relationship between a resilience index, telomere length, and brain structure. This study aims to assess the relationships between AL, a resilience index, and clinical pain/interference. In this study, 193 Non-Hispanic Black and non-Hispanic White adults 45-85 years old, with/without knee pain participated. Data collected included sociodemographics, health history, Graded Chronic Pain Scale (GCPS), and blood samples. AL score was determined by a high risk value of 1 for each measure in the upper quartile for systolic blood pressure, diastolic blood pressure, waist-to-hip ratio, heart rate, fibrinogen, c-reactive protein, and cortisol, and the lower quartile for insulin-like growth factor-1, albumin, and dehydroepiandrosterone (0-10 score). The resilience index was comprised of tobacco use, waist-to-hip ratio, optimism, affect, active coping, perceived stress, and social support. Two-level scoring was used based on clinical norms or median split with higher scores indicating greater resilience (0-8 score). Spearman correlations and adjusted regression analyses were completed using SAS V 9.4. Resilience was inversely associated with GCPS Intensity (rs=-0.26, p=0.0004) and Interference (rs=-0.32, p<0.0001). GCPS Intensity (coefficient=0.16856, p=0.0198) and Interference (r=0.23978, p=0.0008) were positively associated with AL. The resilience index (t=-2.07, p=0.0395) was predictive of AL in an adjusted analysis including age, sex, and ethnicity/race but was not significant when including GCPS Intensity or interference. Resilience was associated with pain and AL, however a biological buffering effect for pain was not demonstrated. AL is a more dynamic measure than telomere length. Additionally, the current AL composite is relative to the sample, a clinically validated measure may be more informative. Further development and refinement of a biologically sensitive resilience index would have significant clinical utility. Grant support from National Institutes of Health/National Institute on Aging [R01AG054370; R37AG033906; T32AG049673; P30 AG059297-01]; the University of Florida Clinical and Translational Science Institute [UL1TR000064]; the University of Alabama at Birmingham Center for Clinical and Translational Science Institute [UL1TR000165] and the Inter-NIA Center Pilot Proposals on Life Course Perspectives on Aging and Resilience and Reserve in Aging.