This article summarises and critiques various tools available for the assessment of pain in older people with cognitive impairment. Definitions of pain are numerous and are not always relevant to people with cognitive impairment because these individuals are often unable to describe or communicate their pain. This makes it difficult for healthcare professionals to assess the absence or presence of pain in these patients. The aim of this article is to establish which of the available pain assessment tools are most appropriate for use in older people with cognitive impairment. From a review of the literature, the authors conclude that pain assessment in older people with any degree of cognitive impairment is complex and there is no gold standard.