The effect of introducing an Acute Pain Service into a District General Hospital was evaluated by conducting an audit of pain, emesis, sleep and satisfaction before and after inception. A total of 1518 questionnaires were collected, in which surgical patients had been asked to assess their experience pre- and postoperatively. The introduction of an Acute Pain Service significantly (p < 0.0001) improved in-patient perception of pain relief upon return of consciousness after anaesthesia and for 2 days postoperatively, when compared with the experience before its inception. The incidence of emetic sequelae did not increase and both patient satisfaction (p < 0.001) and sleep pattern (p < 0.05) in hospital were significantly improved. An estimate of the economic benefit suggests that the development of Acute Pain Services may be cost effective as well as providing an improved quality of service for patients undergoing surgery.