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The Pain Elemental is a monster that does not attack on its own. Their only attack is to spit out Lost Souls, so generally, the Pain Elemental must be killed before fighting off the Lost Souls, or else ammo is wasted in the process. In Doom 64, they look more vicious, have two mouths instead of one, and spit out two lost souls at a time instead of one. Pain Elementals are capable of being triggered into monster infighting, just like every other Doom monster, but because their only ability is spawning Lost Souls, they are unable to actually injure the other monsters.

The Pain Elemental also appears in the Playstation and Saturn versions of Doom, as early as the first level of The Ultimate Doom part of the game on Ultra-Violence difficulty.

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