One complication of breast cancer treatment is lymphedema of the ipsilateral arm. The one-third of lymphedema patients who experience pain report more functional interference, psychiatric symptoms, and distress related to intrusive and avoidant thoughts than patients without pain. Lymphedema patients with pain also report higher levels of body image disturbance and decreased sexual drive. We present a case example illustrating how pain can undermine rehabilitative efforts and detract from quality of life. In addition, the most common causes of pain in patients with upper extremity lymphedema are discussed. Pain related to lymphedema is a neglected aspect of this often overlooked problem in breast cancer survivorship.