Background: Pediatric patients frequently present to emergency departments in pain. Aim: A cross-sectional prospective study was conducted to investigate the prevalence of acute pain in children attending the ED and arriving by ambulance, as well as the initial ED management of pain. We describe pediatric pain management practices in the pediatric ED, as well as parental pain relief. Method: Demographic data, medications, and type of transport to hospital were noted. Pain was assessed upon admission and 30 minutes after administration of analgesia. To standardize pain evaluations, only children aged 4 years or older were included in the study. A numeric rating scale was used to assess pain intensity. Results: The study group consisted of 124 patients. More than 80% of the patients suffered from trauma, injuries to the extremities were the most common cause of admission, and the patient population showed male predominance (62.1%). Over half of the patients (64.51%) were transported by ambulance. Analgesia was administered in 63.5% of the ambulance cases in contrast to only 13.3% of children brought by their parents. Treatment was significantly related to severity of pain. Conclusions: Both medical emergency teams and parents administered prehospital analgesia insufficiently and without previous assessment. However, medical emergency teams used medications more often than parents. Analgesic therapy used in the emergency department resulted in significant pain reduction.