BACKGROUND Acute pain is a sudden experience secondary to injuries and varies in perception among individuals. In trauma patients, it can negatively affect respiratory function, immune response, and wound healing, making it a significant public health concern. This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients. METHODS: A multicenter cross-sectional study was conducted. Data were collected via interviewer-administered questionnaires and patient chart review. The data were analyzed via the statistical package for social science version 25. Bivariable and multivariable logistic regression analyses were used. Variables with a P-value <0.05 were considered statistically significant. RESULTS: A total of 397 patients were included in the study, for a response rate of 96.8%. The prevalence of pain during admission was 91.9% (95% confidence intervals [95% CIs]: 88.8%-94.4%). Blunt trauma (adjusted odds ratio [aOR]=2.82; 95% CI: 1.23-6.45), analgesia before admission to the emergency department (aOR=2.71; 95% CI: 1.16-6.36), documentation of pain severity in the chart (aOR=2.71; 95% CI: 1.16-6.36), analgesia provided within two hours after admission (aOR=7.60; 95% CI: 2.79-20.68), use of non-pharmacological pain management methods (aOR=3.09; 95% CI: 1.35-7.08) and availability of analgesia (aOR=3.95; 95% CI: 1.36-11.43) were associated with acute pain experience. CONCLUSION: The prevalence of acute pain among emergency trauma patients was high in the study area. Analgesia should be administered prior to admission, and non-pharmacological pain management should be implemented. Moreover, training on pain assessment and management should be provided for healthcare providers in the emergency department.