This prospective study with long-term follow-up investigated the prevalence of chronic pain after surgery in Spanish adolescents, in contrast to most studies that have focused on adolescents in North America. The aim was to evaluate the impact of healthcare systems on pain management in pediatric surgery in Spain, where the healthcare model is different from that of North America. 159 children and their parents were included, and pain was evaluated at six different time points up to 24 months after surgery. The prevalence of chronic pain after surgery in the population of Spanish adolescents was found to be 41%. It is worth noting that this prevalence is slightly higher than that reported in studies conducted in North America. This suggests that different healthcare systems may have an impact on pediatric pain management. Therefore, further studies are needed to compare the prevalence of chronic pain in pediatric patients undergoing surgery in different regions and to better understand how healthcare systems can influence pain management.