AbstractThe goal of the current study was to examine the relationship between mothers' spontaneous facial expressions of pain and fear immediately preceding their infants' immunizations and infants' facial expressions of pain immediately following immunizations. Infants' observations of mothers' faces prior to immunization also were examined to explore whether these observations moderated the effect of mothers' facial expressions on infant pain. The final sample included 58 mothers and their infants. Video data were used to code maternal facial expressions, infants' observations, and infants' expressions of pain. Infants who observed their mothers' faces had mothers who expressed significantly more fear pre‐needle. Furthermore, mothers' facial expressions of mild fear pre‐needle were associated with lower levels of infants' pain expression post‐needle. A regression analysis confirmed maternal facial expressions of mild fear pre‐needle as the strongest predictor of infant pain post‐needle after controlling for infants' observations of mothers' faces. Mothers' subtle facial expressions of fear may indicate a relationship history of empathic caregiving that functions to support infants' abilities to regulate distress following painful procedures. Interventions aimed at improving caregiver sensitivity to infants' emotional cues may prove beneficial to infants in pain. Future directions in research are discussed.