Recent evidence suggests that long-term use of 3,4-Methylenedioxymethamphetamine (MDMA; ecstasy) adversely affects brain serotonergic functioning. As serotonin is intimately involved in pain modulation, a potentially important area of investigation is MDMA's effects on the experience of pain. Only one previous study has examined this issue, reporting decreased cold pain tolerance in regular MDMA users. The aim of the present study was to evaluate psychophysical responses to a variety of noxious thermal and pressure stimuli in MDMA users and controls. Twenty-seven regular MDMA users were compared to 27 age- and sex-matched controls with no history of MDMA use. The groups did not differ in heat or pressure pain thresholds, or in ratings of cold pain intensity. However, significant group differences emerged on measures of temporal summation of pain (p's< .05), an index of spinal sensitizability that is implicated in the pathophysiology of chronic pain conditions such as fibromyalgia. In the present study, MDMA users demonstrated enhanced summation relative to controls. Interestingly, within the MDMA-using group, individual differences in lifetime MDA use were unrelated to individual differences in responses to noxious stimuli; subjects with a relatively mild history of MDMA use demonstrated the same degree of exaggerated temporal summation as subjects with the highest lifetime MDMA usage. However, individual differences in pain-related anxiety were significantly associated with heat pain responses within the MDMA group; subjects with relatively higher levels of anxiety demonstrated elevated pain ratings and the largest degree of temporal summation. These findings suggest the possibility that exposure to MDMA may be associated with enhanced responsiveness to repetitive or sustained suprathreshold noxious stimulation, that the threshold for adverse affects of MDMA use on pain processing may be relatively low, and that affective processes (e.g., anxiety about pain) are likely to play a contributory role in MDMA's effects.