Study Objective: We examined the relationship of self-reported pain intensity with vital signs, pain catastrophizing, and anxiety in patients presenting to the emergency department (ED) for acute pain, exacerbations of chronic pain, and acute pain with concurrent chronic (combined) pain and compared the pattern of relationships among these three groups of pain patients. Methods: A convenience sample of patients presenting to the ED with a chief complaint of pain were recruited. Vital signs and self-reported pain intensity at triage were obtained from participants' electronic medical records. After triage, participants completed self-report measures of pain catastrophizing, anxiety, and demographic information. Results: We enrolled 158 adults presenting to the ED with a chief complaint of pain (55 with acute pain, 58 with chronic pain, and 45 with combined pain). No significant associations were found between vital signs and pain intensity at triage in any of the pain patient groups. Pain catastrophizing was significantly associated with self-reported pain intensity in the acute pain group (r=.34, p<.05) and combined pain group (r=.30, p<.05), and state anxiety was significantly associated with self-reported pain intensity in patients presenting with acute pain group (r=.27, p<.05). When pain catastrophizing and state anxiety were used in a stepwise multiple regression analysis to predict self-reported pain intensity pain in the acute pain group, only pain catastrophizing emerged as a unique predictor of pain intensity, β=.405, p<.01. Neither pain catastrophizing nor anxiety were significantly associated with pain intensity in the chronic pain group. Conclusion: Consistent with previous research, vital signs are not associated with self-reported pain intensity in patients presenting to the ED for pain, including those presenting to the ED for exacerbations of chronic pain. Given the significant association of pain catastrophizing and pain intensity among patients presenting to the ED for acute pain (with and without concurrent chronic pain), measurement of pain catastrophizing, a cognitive pain-related variable, may inform pain treatment in the ED.