​Aim: To examine the congruency between patient self-reporting and nurse assessment of pain in the emergency department (ED) through the use of the numerical rating scale (NRS) and visual analogue scale (VAS). Materials & methods: Patient self-reporting of pain and nurse assessments were concurrently conducted using the NRSandVAS.Results&conclusion: Self-reported pain assessment was collected from 200EDpatientsinparallelwiththeircorrespondingnurse-reportedpainscores,conductedby67EDnurses. Althoughnurse–patient painscoring wasassociated withahighcongruencyusingbothNRSandVAS(88.2 and 91.5%, respectively), nurses still underestimated patients’ pain intensity using both tools (t = 2.37 and 2.60; p = 0.007 and 0.010 and CI: 0.17–1.1 and 0.06–0.46, respectively). Some nurse–patient characteristics showed relationships with a discrepancy in pain scoring.​​