Background - Pain is a global public health issue and represents a major clinical, social, and economic problem. Pain left untreated or treated inadequately, can be harmful by slowing recovery and compromising quality of life. Poor Nurses knowledge and inappropriate practices are major contributing factors in improper management of pain. Objective: The study was designed to assess the knowledge and pharmacological Pain management practices among nurses working in public hospitals in Bahir Dar City 2017. Methods: An institutional based cross-sectional survey was conducted from February 25- march 30, 2017. A total of 302 nurses were the participants all inclusively. Data were collected using structured, self administered questionnaire. Descriptive statistics such as frequencies and percentages were used to measure level of knowledge and practices pharmacological pain management. Possible barriers were work overload and absence of guideline on pain management practices were reported as a barrier for pain management by 17.8% and 14% of the respondents respectively. Results: A total of 302 responses were included in the analysis resulting response rate of (95 %). The respondents were drawn from Felege Hiwot Referral hospital and Addis Alem Hospitals. The overall level of knowledge and practices of nurses were 65% and 60% respectively. Conclusion and recommendations: The finding of this study showed that nearly two out three of nurses were knowledgeable regarding pharmacological pain management. However, three-fifth of the respondents found to perform activities required to manage. The nurse should identifies patients in pain, assessing pain, offering treatment options, documentation, provide information on the possible side effect of analgesics and follow-up