OBJECTIVE: This study evaluates the presence of culture and gender differences in pain thresholds and pain tolerance levels between Middle Easterners and Swedes. METHODS: Sixty-four healthy individuals, 32 Middle Easterners (16 men and 16 women, mean age: 24.6 +/- 3.4 years) and 32 Swedes (16 men and 16 women, mean age: 24 +/- 3.5 years) participated in the study. Three experimental pain tests were conducted in each participant. Pain thresholds and pain tolerance levels were measured using an algometer (mechanical stimulus), the PainMatcher((R)) (electric stimulus) and cold pressor test (thermal stimulus). RESULTS: While no significant differences in pain thresholds were observed between Middle Easterners and Swedes in algometer and cold pressor tests, differences in pain tolerance levels were significant (P < 0.01 for both tests). All between-culture differences in pain perception, pain threshold and pain tolerance level were non-significant when measured with the PainMatcher. Significant between-gender differences were observed only in pain threshold with the PainMatcher (P < 0.05) and in pain tolerance level with the algometer (P < 0.01) and the PainMatcher (P <0.001). CONCLUSION: This study found significant differences in two out of three pain tolerance level tests - but not pain threshold tests - between the Middle Eastern and Swedish cultures and between genders. These differences were more pronounced between Middle Eastern and Swedish men than between Middle Eastern and Swedish women. Gender differences were more pronounced within the Swedish than the Middle Eastern culture. These findings indicate that culture and gender influence pain experience.