Pain is a common symptom in people with chronic obstructive pulmonary disease (COPD) which negatively influences quality of life and psychological well-being. However, our understanding of how those with COPD interpret the experience of pain is very limited.To explore how individuals with moderate to severe COPD experience pain.Eight patients diagnosed with COPD who reported experiencing pain for greater than three months participated in in-depth interviews. Transcripts were subjected to interpretative phenomenological analysis.Five themes were identified: 1) pain complicates the clinical profile of COPD; 2) uncertainly of the pain experience: frustrations related to health care professionals' explanation for their pain and the need to legitimize; 3) language and behavior of pain: portraying pain as frustrating and unpredictable; 4) psychological reactions toward pain: depression and fear-avoidance behavior; and 5) altered identity perception: reduced self-worth, guilt in not meeting the expectations of others.Patients report difficulty in explaining the persistence of pain. This fosters a need to legitimize their pain, which influences feelings of frustration and self-worth. An understanding of these responses will assist health care professionals in managing on-going pain in those with COPD.