Background.Pain while waiting for surgery may increase healthcare utilization (HCU) preoperatively.Objective.Examine the association between preoperative pain and HCU in the year prior to gynecological surgery.Methods.590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory.Results.33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n=360) reported a total of 2026 healthcare visits, with 21% (n=126) reporting six or more visits in the year before surgery. After controlling for covariates, women with moderate to severe (>3/10) pain intensity/interference reported higher odds of overall HCU (≥3 pain-related visits to family doctor or specialist in the past year or ≥1 to emergency/walk-in clinic) compared to women with no or mild pain. Lower body mass index (BMI < 30 versus ≥30) and anxiety and/or depression were associated with emergency department or walk-in visits but not visits to family doctors or specialists.Conclusions.There is a high burden of pain in women awaiting gynecological surgery. Decisions about resource allocation should consider the impact of pain on individuals and the healthcare system.