This study explores the role of temperament in pediatric pain perception and responses. The sample consisted of 3- to 7-year-olds (N = 137) who required preoperative blood test by venipuncture. Blood sampling procedures were videotaped. Children's pain responses were measured by their behaviors, pulse oximetry, and self-report of pain. Parents reported their child's usual pain behaviors, previous pain experiences, and temperament. The temperament category threshold was found to relate to self-report and distress behaviors during the preparation phase. The temperament categories of activity, mood, approach, adaptability, intensity, and threshold related to children's previous pain responses and usual pain behaviors. These previous behaviors were strong predictors for their responses to venipuncture pain.