This study investigated the factor structure and psychometric properties of the Pain Anxiety Symptoms Scale (PASS). The PASS assesses four components of pain-related anxiety: cognitive, fear, escape/avoidance, and physiological. Confirmatory factor analyses provided support for both the one-factor and the four-factor structures reported for samples of clinic-referred pain patients. The alpha coefficients were high for the PASS subscales. Significant gender differences were obtained on the PASS total and subscale scores. Convergent and divergent validity estimates of the PASS were also assessed. Results may be used to evaluate the responses of clinic-referred pain patients.