Children with cancer often receive less adequate pain management than adults. This survey was designed to examine current practices, knowledge, and attitudes pertaining to pediatric pain management in China. Based on the choice of opioid use and self-identification as having a conservative or liberal approach to pain management, we identified two clusters. Members of cluster 1 (60%) had more conservative attitudes and did not perceive that young children experienced pain. Members of cluster 2 (40%) had more liberal attitudes. Four factors predicted conservative membership: never having prescribed opioids for cancer pain (OR = 2.67, CI = 1.11-6.45), use of placebos for pain management (OR = 2.32, CI = 1.05-5.08), belief that the adequacy of pain management was fair or good (OR = 2.10, CI = 1.31-3.37), and belief that children are less sensitive to pain (OR = 1.96, CI = 1.02-3.76). The top barriers to optimal pediatric pain management were identified as fear of opioid addiction and inadequate knowledge of pain management. © 2003 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.