Aim To investigate analgesic use and pain in people with and without dementia in Australian residential aged are facilities. Methods A cross‐sectional study of 383 residents of six residential aged are facilities was conducted. Nurses assessed self‐reported and clinician‐observed pain. Analgesic use data were extracted from medication charts. Logistic regression was used to investigate factors associated with analgesic use. Results Analgesics were administered to 291 (76.0%) residents in the previous 24 hours. The prevalence of analgesic use was similar among residents with and without dementia (79.3% vs 73.4%, P = 0.20). Residents with dementia had a higher prevalence of self‐reported pain than those without dementia but similar prevalence of clinician‐observed pain. In residents with dementia, high care residence and dementia severity were associated with analgesic use. Conclusion The prevalence of analgesic use was similar among residents with and without dementia. Both self‐reported and clinician‐observed measures are needed in regular pain assessments.