Purpose: The purpose of this integrative review is to investigate the degree of variability in the prescribing approaches to acute pain management in the emergency department (ED) setting. Variations in analgesic prescribing among ethnic and racial minorities as they compare to non-minority patients with similar complaints of pain will be examined. Data Sources: A comprehensive review of the literature was conducted using MEDLINE, PubMed, and CINAHL databases. Inclusion criteria of the studies were: US studies; published between 2002 and 2012; English language; with at least one aim or analysis comparing prescription of analgesia between a racial or ethnic minority and non-minority group in the ED. Key words used to obtain relevant articles included pain management; analgesia prescription; minority; race; ethnicity; emergency department; disparities. Conclusion: A research summary concluded that racial and ethnic disparities in pain management continue to exist in the ED setting. When compared to Caucasian patients, African American and non-white ethnicities were less likely to receive analgesia. Language barriers, experience of providers, and trust were among the contributors to pain management disparities. Implications for Practice: The role of the nurse is to incorporate cultural competence in assessing and achieving equitable pain management across all racial/ethnic groups.