Cognitive-behavioral therapy has become a common nonpharmacologic treatment option for individuals experiencing chronic nonmalignant pain. This article begins with an overview of the cognitive-behavioral perspective on pain and pain management. The second section discusses relevant developmental issues and suggests refinements to cognitive-behavioral therapy for the elderly, followed by a case example describing the implementation of cognitive-behavioral therapy for an elderly gentleman in an ambulatory care setting. The details of assessment, treatment conceptualization and planning, intervention, and follow-up are explored in this context. This article concludes with suggestions for future refinements in the application of this approach in the management of chronic pain in the elderly.