OBJECTIVE: To examine the association of pain catastrophizing to pain experience and a history of childhood sexual abuse in women with chronic pelvic pain (CPP) of gynecologic origin. STUDY DESIGN: Cross-sectional study of women with CPP (N=273) attending a tertiary care obstetrics and gynecology pain clinic. Subjects completed standardized questionnaires to assess pain intensity, pain interference with daily activity, pain catastrophizing, severity of depressive symptoms, and a history of childhood sexual abuse. RESULTS: Correlational analysis indicated, that pain catastrophizing, pain intensity, pain interference and depression scores all shared significant association. Multiple regression analysis indicated that, after controlling for the influence of depressive symptoms on both pain intensity and pain interference, pain catastrophizing significantly predicted both pain outcome measures. After controlling for pain catastrophizing, depressive symptoms were found to significantly influence pain interference but not pain intensity. Of the abuse measures, only women who reported major sexual abuse in childhood were found to endorse more severe pain catastrophizing. CONCLUSION: Pain catastrophizing appears to be an important variable in understanding the pain experience of women with chronic pelvic pain. More over, the presence of a history of major sexual abuse in childhood may be an additional risk factor for pain catastrophizing in this population, contributing to further pain morbidity.