Pain is a public health problem and affects millions of people globally. Analysed medical literature reveals a concerning gap of up to 30% of healthcare professionals lack training in pain assessment and management. Effective pain management is essential and possible through comprehensive pain management guidelines, trained healthcare professionals and adequate facilities. It helps ensure patient recovery, comfort and overall quality of life. However, studies suggest that health care professionals often demonstrate varying levels of competency in pain assessment and management. The objective of this study is to assess the healthcare professionals’ competency in pain management in Meru Teaching and Referral hospital and St Teresa mission hospital Kiirua. Design was a Cross-sectional study (Mar 23– May 5, 2025). Participants were 154 Health Care Professionals (22 doctors, 31clinical officers, 101 nurses). Tool Used was Adapted KASRP questionnaire. The practice questions and observation checklist questions were developed from literature review. Ethics approval from MIRERC, NACOSTI, Meru County Research office, MeTRH and STAMHK administration and a consent from participants were sought. Analysis was by descriptive, Chi-square, logistic regression, and multinomial logistic regression at a Significance set at p< 0.05. N= 135. The Mean Knowledge on pain assessment total scores obtained by doctor, clinical officers and nurses were (32.7222, N=18), 28.4333, N=30), (30.4419, N=86) respectively. 17(89.5%) out of 19 questions assessing the HCPs skills in pain management were answered correctly. (41.5%) healthcare professionals use the pain assessment tool every time they meet the patients. Clinical officers used it more frequently as compared to doctors and nurses. A significant difference between the KASRP score, sample characteristics and the observation checklist result where (p<0.001) was noted. 48 (100%) of the sampled patient files had a prescription of pain medication, only 11(22.9%) of the files had pain classification and only 2 (4.2%) had finding according to assessment scale documented. Variation of practice exists among healthcare professionals in the utilization of pain assessment tools. Majority participants reported having and following pain management guidelines but only a small percentage use pain assessment tools and document the pain assessment findings. This study highlights the need of improvement in knowledge in order to improve the skills in Pain management among healthcare professionals at MeTRH and STMHK. Competency is contributed to by knowledge, skills and attitudes equally. With these findings, HCP had good knowledge practice and attitude in pain management but poor documentation practices.