Painful experiences (e.g., surgeries, injuries) can be traumatic for individuals of any age, but emerging evidence suggests that adverse experiences and trauma (e.g., emotional and physical abuse and neglect) in early life play a key role in the development of chronic pain problems. Moreover, while research shows that chronic pain can be transmitted across generations, less is known about how and why early adversity and trauma experienced by parents may confer risk for chronic pain in their offspring. Little research has examined the link between exposure to adversity and trauma in early life, how it confers risk for pain within and across generations, and the underlying mechanisms that drive these relationships over time, although it is evident that adverse experiences early in life ‘sets’ the organism to anticipate high levels of threat and mobilize defences, including pain. We are an international, (UK, Canada, Australia), interdisciplinary panel consisting of an epidemiologist (Macfarlane), clinical psychologist (Noel), and developmental neuroscientist (Mychasiuk). From this international collaboration, we will present new, unpublished data from epidemiological, clinical and community cohort, and pre-clinical studies. These studies examine the relationships between physical and emotional adversity and pain across infancy, childhood, and adolescence, how childhood adversity confers risk for chronic pain across generations, as well as the neurobiological, cognitive, behavioural, and interpersonal mechanisms that drive these relationships over time. An interactive discussion will underscore implications of this work, including the need for anti-racist approaches to this research, new categories of adversity to consider (e.g., victimization, discrimination, iatrogenic clinical encounters), adoption of a trauma-informed approach to research and practice, controversies, prevention, the need for application of a structural and systemic lens, and new avenues for community-level interventions beyond traditional CBT approaches.