Background: One of the most common reasons why patients visit the Emergency Department is with the complaints of pain. The compliance rate of pain assessment and reassessment by the nurses in ED is far from expectation. This results in delayed disposition, increased re admission and poor patient satisfaction. As pain is exclusively a subjective experience, accurate documentation of patient pain assessment is critical in the management of pain. Methods: The study was conducted in the Emergency Department of Hamad General Hospital. The prospective data was collected for a period of two months (January to February 2015) using a direct observation technique by the ED nurses and verified by the study observer for the accuracy of the data. Sample was collected from various sections of ED (Male triage area, Female triage area and short stay units). Both male and female patients were included in the sample. Results: Male area The use of pain scale improved from 63% to 83%. Non-compliance to reassessment after intervention decreased from 58% to 32% which shows improvement 74% of the observation was not following the international timing of the reassessment after intervention then decreased to 73% Female area The use of pain scale improved from 80% to 90% Non-compliance to reassessment after intervention decreased from 93% to 4% which shows improvement 80% of the observation was not following the international timing of the reassessment after intervention then decreased to 32%. Conclusions: An accurate assessment and reassessment of pain is critical in the management of pain. Meticulous teaching and following the hospital standard is important to achieve 100% compliance with pain assessment.