This study explored the ways in which racially and ethnically diverse patients differ in their perceptions of the cancer pain experience, barriers to treatment, and satisfaction with treatment. This cross-sectional descriptive study was conducted at four cancer treatment centers and one cancer clinic in the southeastern United States and included 66 White, African-American, Latino, and American Indian cancer patients experiencing pain related to disease or disease progression. Pain Management Index (PMI) scores were calculated and subjects provided responses to the Cancer Pain Experience questionnaire, the Barriers Questionnaire, and a modified American Pain Society Satisfaction Survey. African-Americans reported a low PMI score. Whites reported the lowest mean level of agreement with all statements about barriers to pain relief. Addressing differences in patient beliefs about what constitutes successful pain treatment and treatment satisfaction, caregiver behaviors, and system characteristics might improve the quality of care and possibly reduce the mortality of cancer patients with pain.