Prior studies of alexithymia in chronic pain patients have used unvalidated alexithymia measures or have not controlled for treatment-seeking status. In this study, we compared 30 patients with chronic pain and patients seeking treatment for two other problems: nicotine dependence (n = 32) or moderate obesity (n = 25). Alexithymia was assessed with the well-validated Toronto Alexithymia Scale (TAS) and also with the Alexithymia Provoked Response Questionnaire (APRQ). On both alexithymia measures, chronic pain patients were more alexithymic than nicotine-dependent and obese patients; the latter two groups did not differ. Chronic pain patients had greater psychopathology on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and both alexithymia measures correlated positively with certain types of psychopathology. We conclude that alexithymia is increased among patients with chronic pain, that this relationship is not confounded by a treatment-seeking bias, and that alexithymia may contribute to both chronic pain and psychopathology.