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Heightened fear of pain is related to biases in initial orienting, but not maintenance, of visual attention based on eye-movement tracking and reaction time indices.This research examined selective biases in visual attention related to fear of pain by tracking eye movements (EM) toward pain-related stimuli among the pain-fearful. EM of 21 young adults scoring high on a fear of pain measure (H-FOP) and 20 lower-scoring (L-FOP) control participants were measured during a dot-probe task that featured sensory pain-neutral, health catastrophe-neutral and neutral–neutral word pairs. Analyses indicated that the H-FOP group was more likely to direct immediate visual attention toward sensory pain and health catastrophe words than was the L-FOP group. The H-FOP group also had comparatively shorter first fixation latencies toward sensory pain and health catastrophe words. Conversely, groups did not differ on EM indices of attentional maintenance (i.e., first fixation duration, gaze duration, and average fixation duration) or reaction times to dot probes. Finally, both groups showed a cycle of disengagement followed by re-engagement toward sensory pain words relative to other word types. In sum, this research is the first to reveal biases toward pain stimuli during very early stages of visual information processing among the highly pain-fearful and highlights the utility of EM tracking as a means to evaluate visual attention as a dynamic process in the context of FOP.