Acute pain is the most common and prevalent reason for emergency department (ED)rnvisits with a prevalence of over 70% in the world. The study aimed to assess thernadequacy and appropriateness of pain management practice at Aabet Hospital. Anrnobservational prospective study was conducted at Aabet hospital from December 1, 2020rnto March 30, 2021. Adult traumatic patients having pain (at least score 1 on the NumericrnRating Scale) with a Glasgow Coma Scale score >13 were eligible to participate in thernstudy. The pain intensity was evaluated at the time of admission, at 60, 120, 180, and 240rnminutes. The time of first analgesics was registered. The adequacy and thernappropriateness of the pain management practice were calculated through the painrnmanagement index (PMI) and Pain Medication Appropriateness Scale (PMAS),rnrespectively. Two hundred thirty- two (232) participants were included in this study afterrnobtaining their consent. The majority of the participants 126 (54.3%) were admitted duernto road traffic accident followed by falls 44(19%). Only 21 (9.1%) study participantsrnreceived the first analgesic treatment within 30 minutes while 27(11.6%) participants hadrnno treatment. Among the study participants 72 (31%) received non opioids, 59 (25.6%)rnreceived weak opioids, and 37 (15.9%) received strong opioids. Nearly half 110 (47.4%)rnof the study participants were treated inadequately (PMI (-) score) and nearly two-thirdrn(140 (60.3 %)) of the participants were treated inappropriately. The type of analgesiarnadministered, time to analgesia and pain intensity could predict 65% of variance in PMIrnscore (Rrn2rn= 0.65, P= .001). From this study it can be concluded that acute pain inrntraumatic patients was under and inappropriately treated. Thus, the clinical practitionersrnshould to stay vigilant towards acute pain management in the trauma center.