Recent diagnostic criteria of autism include insensitivity to pain as a specific example of this abnormality. Research evidence here is however limited. The suggestion of altered pain responsivity in autism is distressing as pain may be the first or only sign of illness or injury and autistic individuals may be at greater risk of injury or illness than their peers. This talk will consider what we mean when we think of pain, what it might mean to have altered pain sensitivity and some implications of misinterpreting these data. This will also consider evidence from recent studies seeking to identify differences in pain processing in autistic adults. Here we will consider what we know about how painful stimuli might be experienced from the initial coding of the stimulus in the periphery to the neural coding and finally behavioural response of these individual to communicate pain. We will consider here evidence from basic laboratory studies through to codesigned interviews giving a voice to autistic people to express their pain. Finally, we will consider the beginnings of research we are undertaking which is designed to explore how autism might alter the experience of chronic pain management.