Multiple factors have been reported to be barriers to effective control of pain in patients with advanced disease and insufficient education and knowledge have been ranked high among others. The concept of palliative care in Rwanda is under development and there are no national prevalence statistics about pain management. The information available concerning pain management among patients with advanced disease is especially limited, although many of our patients suffer from pain associated with advanced disease i.e. where the goal of care is not cure or where cure is not an option. The present book is grounded on the belief that medical doctors are important mediators of effective pain management and they should be more knowledgeable and updated on effective pain management. The findings revealed widespread deficit of knowledge and poor attitude of medical doctors' regarding pain management at two referral hospitals in Rwanda. Education and quality improvement initiative in effective pain management are recommended.