In this exploration of the problem of assessing children' pain in intensive care units (ICUs), literature spanning the last 10 years was reviewed to identify factors that affect pain assessment, such as developmental stage, health professionals' attitudes and myths. Selected pain assessment tools are briefly described and evaluated for use in intensive care with children.Although this review is small, it is clear that despite nurses' recognition of the need for pain assessment in children, and the appearance of many new assessment tools, health professionals may still not be managing paediatric pain effectively. The search also revealed that little appears to have been written about this problem as it occurs in ICUs, and more research is indicated.