The aim of this chapter is to focus on the special situations in pain management. Pain medicine can be full of challenges. One of the important and difficult parts of it is to manage pain in special situations like renal or gastrointestinal (GI) or hepatic or respiratory or cardiac dysfunction cases. Patients who are pregnant and are breastfeeding also pose challenge in some cases where good pain management is required. Geriatric population and infants are again can be tricky to analyze and treat pain due to changes in their physiology. Following special situations for prescribing pain medications with case examples are gastrointestinal tract dysfunction, renal dysfunction, hepatic dysfunction, respiratory dysfunction, cardiac dysfunction, pregnant and breastfeeding, and geriatric patient described in this chapter. In this chapter, nine cases are discussed.