Research has demonstrated that cannabis use is linked with a greater risk of psychotic-like experiences (PLEs), particularly in young people. As many use cannabis for the alleviation of pain, it is important to examine the impact that PLEs have on pain. This is because current literature finds that psychotic and schizophrenic disorders impact pain experience, and PLEs are subclinical positive symptoms of psychosis. There is limited research on the impact of PLEs on pain experience, particularly in cannabis users, and thus the current study aims to address this gap in the literature. The study also examines whether childhood trauma and mental health problems contribute to the heightened risk of pain in cannabis users, and whether these relationships are moderated by PLEs. The current study was a cross-sectional design using baseline data from the ‘Keep It Real’ randomised controlled trial (N = 2630). Participants completed questionnaire measures of cannabis use, PLEs, self-reported pain, childhood trauma, anxiety, and depression. Logistic regression analyses revealed that young cannabis users experiencing more PLEs reported significantly higher pain. Additionally, experiencing a history of childhood trauma and depression were also found to result in higher pain in these cannabis users. Moderation analyses revealed that PLEs moderated the relationship between depression and pain; however, in contrast to our predictions, PLEs did not moderate the relationship between childhood trauma history and pain. Anxiety did not significantly predict higher pain. The results of the current study have important implications for the use and legalisation of THC medically and the social, emotional, and cognitive aspects of pain and cannabis use. We propose recommendations for mitigating the risk of PLEs associated with cannabis use in chronic pain patients medically prescribed THC for its analgesic effects and suggestions for future research.