Managing post-surgical pain is critical for successful surgical outcomes. One of the challenges of pain management is accurately assessing the pain level of patients. Self-reported numeric pain ratings are limited because they are subjective, can be affected by mood, and can influence the patient’s perception of pain when making comparisons. In this paper, we introduce an approach that analyzes 2D and 3D facial keypoints of post-surgical patients to estimate their pain intensity level.Our approach leverages the previously unexplored capabilities of a smartphone to capture a dense3D representation of a person’s face as input for pain intensity level estimation. Our contributions are a data collection study with post-surgical patients to collect ground-truth labeled sequences of2D and 3D facial keypoints for developing a pain estimation algorithm, a pain estimation model that uses multiple instance learning to overcome inherent limitations in facial keypoint sequences, and the preliminary results of the pain estimation model using 2D and 3D features with comparisons of alternate approaches.