Purpose: Pain without an organic cause may be the result of many psychiatric disorders and difficulties in social, educational, and relational life areas for children and adolescents. The aim of this study was to determine the effects of alexithymia on pain without an organic cause and psychiatric symptoms in children and adolescents. Methods: Fifteen patients with depression, 21 patients with complaints of pain, and 15 controls, all age and sex matched, were evaluated and compared for alexithymia, depression, and anxiety rated by the Toronto Alexithymia Scale (TAS), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory for Children (STAIC). Results: Although the lowest mean TAS score was in the control group (9.3±2.8) and the highest grade was in the pain group (11.2±4.0), there was no statistically significant difference between the groups (p>0.05). The three groups did not significantly differ with regard to anxiety levels, but depression level was significantly higher in the depression group (18.0±10.8) than in both the pain (9.6±7.0) and control (9.0±2.8) groups (p=0.005). In the pain group, alexithymia scores were significantly (p<0.01) and positively (r=0.433 and 0.435, respectively) correlated with STAIC-I and STAIC-II scores. In a multiple regression model for alexithymia scores in the depression and pain groups, none of the socio-demographic factors significantly affected the TAS scores (p>0.05). Conclusions: This study shows that children and adolescents with non-organic headache/abdominal pain are not significantly more alexithymic than depression patients and controls. Anxiety may be a risk factor for the development of pain without an organic cause in alexithymic children and adolescents.