The primary aim of this study was to determine if the immediate outcomes of multidisciplinary pain rehabilitation were different for African Americans compared with Caucasians. A retrospective repeated measures design was used, and all analyses were adjusted for marital and employment status, years of education, and pain duration. Multidisciplinary pain rehabilitation center. Each African American (N = 40) consecutively admitted to a multidisciplinary pain rehabilitation program was matched with three Caucasians (N = 120) on age, sex, and treatment dates. A 3-week outpatient multidisciplinary pain rehabilitation program. The Multidimensional Pain Inventory, Short Form-36 Health Status Questionnaire, Center for Epidemiologic Studies-Depression scale, and Pain Catastrophizing Scale were administered at admission and dismissal. At baseline, African Americans had greater pain severity (P < 0.001) and poorer physical function compared with Caucasians (P < 0.001). At program completion, African Americans had greater pain severity (P < 0.001) and poorer measures of life interference (P = 0.004), perceived control (P = 0.013), affective distress (P < 0.001), role physical (P = 0.001) and role emotional function (P = 0.001), physical (P < 0.001) and social function (P = 0.002), general health (P = 0.005), depression (P < 0.001), and pain catastrophizing (P < 0.001). A repeated measures analysis demonstrated a time by race interaction effect for pain interference (P = 0.038), affective distress (P = 0.019), role physical function (P = 0.007), social function (P = 0.029), and depression (P = 0.004), indicating African Americans experienced less improvement compared with Caucasians. The results of this study highlight an under-recognized health disparity which provides the basis for developing targeted interventions aimed at improving the clinical outcomes of African Americans with chronic pain.