Introduction: Despite major improvements in burn wound management and survival, the burn pain management is inadequately treated globally.Aim: To assess the health care workers' (HCWs) adherence to burn pain management guidelines in governmental hospitals in Palestine.Methods: A triangulated, descriptive and cross sectional approach was used. All doctors and nurses (No., 53), who are working at burn centers in Gaza were included in the study. Four tools were used to collect the data: A questionnaire to assess knowledge about the protocol; a checklist to assess the adherence; an assessment checklist of physical environment; and in-depth interviews of key medical staff.Findings: The study found knowledge level of pain management guidelines was 44.9%, and the adherence level was only 12.8%. Only 47% of participants were aware of the presence of Palestinian national protocols for burns care and management. Furthermore, 80% of them didn't receive training courses about the guidelines. About 68% reported no follow-up by the management to ensure the implementation of the protocol. Moreover, there is a severe shortage of most specialties in the multidisciplinary medical team and medical supplies. There is underutilization of non-pharmacological methods in the pain management. Conclusion: There is huge deficit in adhering to burn management guidelines among HCWs in Gaza Strip. Managerial policies, continuing education and training programs for burn team are crucial steps to promote adherence.