Abstract Background Pain is common at an emergency department (ED). Two common scales used to rate intensity are the visual analog scale (VAS) and the numeric rating scale (NRS), but it remains unknown which is superior to use in the ED. Aim The aim of the study is to compare correlations between values on the VAS and the NRS in patients visiting the ED as well as to assess the patients' preference of scale. Methods Patients who visited the ED due to chest pain, abdominal pain, or an orthopedic condition during autumn 2012 were enrolled onto a cross-sectional study with a consecutive sample. Patients rated their pain using the VAS and NRS scales. They answered an open-ended oral questionnaire regarding their preference and their estimation of the sufficiency of the scales. Data were analyzed with significance test. Results In all, 217 patients (70% of eligible, 94% of invited) participated. The pain scores generated from the NRS and the VAS were found to strongly correlate (mean difference, 0.41; 95% confidence interval, 0.29-0.53). Most patients found the NRS easier to use than the VAS (61% and 22%, respectively; P < .001). Furthermore, a majority reported that the NRS reflected/described their pain better than the VAS (53% and 26%, respectively; P < .01). Conclusion Because values on the NRS correspond well to values on the VAS, values rated with different scales over time might be comparable. Because a majority of the patients found the NRS scale simpler to use and preferred it over the VAS, it might be more appropriate to use in the ED.