Chronic pain is a debilitating problem for many Americans. It affects physical, social, and emotional health. This study addresses the potential differential effects of chronic pain cross-culturally in younger Americans. A retrospective analysis of persons younger than 50 years of age presenting for chronic pain management in a multidisciplinary pain center was done. White and black American adults aged 18 to 50 years (N = 3669) were compared to determine whether there were differences in (1) psychologic functioning, (2) pain characteristics, (3) pain disability, and (4) comorbidities. Our results suggest that black Americans had more depressive symptoms and symptoms consistent with post-traumatic stress disorder when compared to white Americans. These results showed that on initial assessment, black Americans with chronic pain report significantly more pain and sleep disturbance as well as more symptoms consistent with post-traumatic stress disorder and depression than white Americans. They also experience a higher prevalence of self-identified comorbidities, including dizziness, chest pain, and high blood pressure. In conclusion, considerable diminution in the overall physical and emotional health of black Americans 18 to 50 years of age with chronic pain was noted. These data support the need for further study of the chronic pain experiences of racial and ethnicity minority persons.