Despite major advances in the field of anesthesia and medicine, postoperative pain continues to be undermanaged in a significant proportion of patients. The consequences of undermanaged pain are deleterious for both patients and the healthcare system. This review aims to give the readers a practical and updated approach to acute postoperative pain management. This chapter deals with the definition of pain, the physiology and pathophysiology of pain, and various approaches to the management of acute pain. A review of the literature was done to understand the methods of pain management with a major focus on the literature of the last decade (2010–2022). A literature search was done on PubMed and Google Scholar using keywords “acute postoperative pain” and “pain physiology.” The research papers on the basics of pain physiology, the prevalence of acute post-operative pain and methods of acute postoperative pain management were reviewed. A brief practical approach for acute postoperative pain using pharmacological and non-pharmacological approaches and a brief discussion have been done on the approach for special group of patients. The management of acute postoperative pain can be done using various pharmacological and non-pharmacological methods. The approach for each patient has to be tailored depending on the individual patient’s needs.