Acute pain relief is an ongoing challenge for both nurses and emergency physicians. Its management remains suboptimal or delayed, despite the existence of valid recommendations. The complexity of the emergency department and the diversity of encountered situations justify a tailored approach, taking into account the patient's clinical characteristics and needs. Such an approach must, under safety conditions assign sufficient autonomy to care providers in order to achieve pain relief. The benefits of an optimal analgesia are numerous. They include a greater patient satisfaction, a reduced length of stay, and a rapid return to mobility. This article highlights the key elements of acute pain management in the emergency department of the Geneva University Hospitals.