INTRODUCTION: The primary aim of this study was to examine the way in which parent stress, including adverse childhood experiences (ACEs) and emotional distress, pain, and resilience, relates to child pain and mental health variables when families are establishing pediatric pain management care. METHOD: Participants included 50 parent/patient dyads who were recruited from an outpatient pediatric pain clinic. The study utilized an observational design, including self-report questionnaires (parents, youth) and chart review. Questionnaires gathered information on parent ACEs, recent emotional distress, pain, and resilience, as well as child pain, anxiety, depression, and global health. The area deprivation index was used to assess family socioeconomic disadvantage, and all data were collected in 2021. RESULTS: Results indicated that higher levels of parent pain severity, disability, and generalized pain were associated with child pain and mental health variables, including higher levels of child generalized pain, anxiety, depression, and worse child global health. Results also indicated that high parent pain disability coupled with higher levels of ACEs increased the risk for child generalized pain. DISCUSSION: Parent factors may impact child pain and mental health variables for youth with chronic pain. Improved understanding of the way in which these parent variables relate to child variables may provide opportunities for improved assessment and care for youth and their families. (PsycInfo Database Record (c) 2025 APA, all rights reserved).