Cancer Pain is a multi-dimensional pain experience which involves diverse neurophysiological changes and is associated with significant cognitive, emotional and sociocultural problems. Globally, the incidence is very high and usually it is undertreated. Lack of knowledge about managing malignant pain is an important cause of undertreatment. All types of pain are possible with malignancies. Assessment of pain characteristics is vital for proper management. The WHO step ladder pattern is the cornerstone of management. There are different pharmacological and nonpharmacological methods. Morphine is the choice opioid being administered by various routes. All drugs should be used as round the clock regimen. Opioid switch is opted to tackle tolerance. Nerve blockade especially with alcohol are still being used. Newer treatment modalities like implantable intrathecal pumps, dorsal column stimulation are in the pipeline for future. A passionate counselling may frequently release knotted conundrum of difficult analgesic strategies.