Previous studies suggest that many patients with burns receive inadequate analgesia. A secondary analysis of the 1992 to 1999 National Hospital Ambulatory Medical Care Survey (a national, weighted sample of emergency department [ED] encounters) was performed to estimate national analgesia prescribing patterns in ED patients with burns. In 1999, there were 21,103 patient encounters sampled from 376 EDs, resulting in an estimated 102.8 million ED visits in 1999. One hundred thirty-eight patients in the sample (0.7%) had burns for an estimated 827,000 annual burns. Patient mean age was 28 years. Forty-three percent were female, 25% were children under 18 years of age, and 81% were white. Pain assessments were performed in about half of the patients, and only half of the patients received analgesics. Analgesia administration did not differ by year, sex, age, race, ethnicity, geographic location, or insurance payment type, yet it was more likely with increased pain. We conclude that many patients with burns do not have documentation of pain assessment or analgesia administration while in the ED.