BACKGROUND: Pain is among the most prevalent symptoms experienced by patients with cancer. Severe pain is incompatible with quality of life. Although cancer pain can be effectively treated in 70-90% of patients with the principle of pain management, between 60% and 70% of cancer patients pain is inadequately treated. Both knowledge and attitudes of medical professionals are important for effective pain management. This study was designed to survey residents knowledge and attitudes toward cancer pain management in order to offer the basic data for researching the problems and education program of cancer pain management. METHODS: In February 1997, we surveyed 116 residents practising in 7 departments of one university hospital, including physicians and surgeons, with a case-oriented questionnaire assessing knowledge and attitudes toward cancer pain management. RESULTS: The percentage of residents choosing the correct answer for knowledge about pain management was, pain in the drug abuser(42.2%), equianalgesic dosing(47.4%), physical dependence(50.9%), WHO analgesic ladder(61.2%), neuropathic pain(62.9%), around the clock dosing(69.8%). The percentage of residents choosing answer for attitude toward cancer pain management ; upper limit to opioid prescription(46.5%), reluctance to prescribe morphine(45.7%), need of education for pain management(99.1%). Fear of side effects was the most frequent reason of their reluctance to prescribe opioids(80.4%.) Physicians had higher level of knowledge than surgeons(P=0.004). CONCLUSIONS: This study shows the presence of barriers to adequate pain control in Korea as identified in other countries. There is the lack of konwledge about cancer pain management and doctors are reluctant to prescribe because of negative attitudes towards pain management. This suggests a need for not simply offering knowledge but problemsolving education and training of pain management.