Coping is one of the most commonly used concepts in the pain literature. Despite its popularity, it remains a broad and confusing concept that is often vaguely defined and poorly operationalized. This chapter presents a motivational model of coping that starts from the idea that pain’s interference with goal pursuit elicits negative affect, which in turn activates coping responses that may then proceed along 3 possible pathways: goal persistence, problem-solving, or goal adjustment. The chapter describes and illustrates these pathways and asserts that all three could be either adaptive or maladaptive, depending upon the nature of the context. It recasts several traditional concepts regarding pain coping, such as pain catastrophizing, fear-avoidance, endurance, pain-related attention, and acceptance, within this motivational perspective. It discusses the potential implications of adopting the motivational account of pain coping for clinical interventions such as exposure, attention management, and acceptance, as well as commitment therapy.