Background: Pediatric pain during hospitalization remains a significant clinical concern. Inadequate and inconsistent pain assessment may lead to suboptimal pain management, negatively affecting children’s comfort, recovery, and overall quality of care. Purpose: This study aimed to explore nurses’ lived experiences in assessing pain among hospitalized children in pediatric wards of a public hospital in Indonesia using a descriptive phenomenological approach. Methods: A qualitative descriptive phenomenological design was employed. Thirteen pediatric nurses participated in two focus group discussions (FGDs) conducted between March and May 2025 in the pediatric wards of a public hospital in Indonesia. Data were analyzed using Colaizzi’s method to identify the essential meanings and patterns underlying nurses’ experiences in pediatric pain assessment. Results: Four main themes emerged from the analysis: 1) methods and tools for pain assessment, 2) pain assessment implementation, 3) challenges in assessing children’s pain, and 4) nurses’ expectations for system-level support and innovation in pediatric pain assessment. Conclusion: Pediatric pain assessment practices are shaped by the dynamic interaction between organizational structures, individual clinical judgment, and broader system-level support mechanisms. While standardized tools exist, sustaining consistent implementation requires strengthened institutional monitoring, continuous professional development, and improved availability of child-specific resources. Nurses also emphasized the importance of practical and integrated innovations to support clinical workflows and decision-making processes. © 2026 Ramdhanie et al.