Objective: Managing painful chronic pancreatitis (CP) often involves invasive treatments, but success rates are variable. We aimed to describe the pain assessment tools used to measure the efficacy of endotherapy and surgery for painful CP and perform a meta-analysis of outcomes. Design: PubMed, Embase, and Scopus databases were searched for published studies through April 1, 2023. Full papers in English that assessed pain outcomes among adults with painful CP undergoing invasive interventions were included. Results: There were 413 out of 1,282 studies that underwent full-text review, and 279 studies were selected for the scoping review. Most commonly used pain assessment tools included symptom description (n=68 studies), numeric pain rating scales (NRS) or visual analog scales (VAS) (n=52), binary pain relief (yes or no) (n=27), and the pancreatitis-specific 4-item Izbicki score (n=28). In a meta-analysis of studies reporting preintervention and postintervention NRS or VAS (0–100), the mean decrease in pain after endoscopic intervention (n=9 studies) was 40.3 (95% CI: 27–53.6, P<0.001) and after surgical intervention (n=12 studies) it was 43.2 (95% CI: 31.5–54.9, P<0.001). A separate meta-analysis of studies reporting the preintervention and postintervention Izbicki score (n=5) showed similar findings. There was no difference in the change in pain scores between endotherapy and surgical cohorts in studies using NRS/VAS or Izbicki scores. Conclusions: Pain outcomes were similar between endotherapy and surgery for painful CP based on the use of simple and highly variable pain assessment tools. Referral bias and sham effects need to be considered in future trials.