The present study examined the long-term pain and disability outcomes of a pediatric chronic pain clinic cohort and evaluated whether these outcomes differed by age and sex. Patients were interviewed a mean of 3 years after their last appointment at a pediatric pain clinic. The cohort comprised 95 females and 48 males, aged 5-23 years when interviewed. Of the cohort, 62.2% (67 females, 22 males) reported continuing pain. Females were significantly more likely than males to report continuing pain (OR=2.9, 95% CI=1.4-5.8, p=.005), use of health care (OR=5.1, 95% CI=1.4-18.5, p=.01), medication (OR=4.7, 95% CI=1.3-16.9, p=.02) and non-drug methods of pain control (OR=3.4, 95% CI=1.3-9.2, p=.02). For patients whose pain had associated psychosocial factors, females (76.4%) were significantly more likely than males (21.4%) to report continuing pain (OR=13.8, 95% CI=3.3-58.4, p=.005). Finally, among patients still experiencing pain, the frequency of pain episodes increased significantly with age (OR=1.3, 95% CI=1.0-1.5, p=.02). Results indicate that chronic pain persists for many children despite treatment at specialized clinics. Females may be at higher risk for continuing pain and report greater use of health care, medication, and non-drug methods of pain control.