Introduction: Understanding pain neurophysiology is vital for effective pain education and management, especially in populations with chronic musculoskeletal pain. The Revised Neurophysiology of Pain Questionnaire (RNPQ) is a widely used tool to assess patients’ conceptual understanding of pain. However, no validated Gujarati version currently exists. Aim/Objectives: To translate and culturally adapt Gujarati version of the Revised Neurophysiology of Pain Questionnaire (RNPQ-G) for use among Gujarati-speaking individuals with chronic musculoskeletal pain. Method: This cross-sectional methodological study followed established guidelines for cross-cultural adaptation, including forward translation, synthesis, backward translation, expert committee review, and pretesting via cognitive interviews with 30 participants. The pre-final version was pilot-tested for clarity and cultural relevance. Subsequently, the final RNPQ-G was administered to a sample of 50 individuals with chronic musculoskeletal pain. Results: The translation and adaptation process was completed successfully. Minor linguistic and cultural adjustments were made during expert review and pretesting to ensure clarity and relevance. Participants reported good understanding of the questionnaire items, and no significant difficulties in comprehension were noted. Conclusion: The Gujarati version of the RNPQ has been successfully translated and culturally adapted. It is comprehensible and culturally appropriate for Gujarati-speaking populations. Further studies are recommended to evaluate its psychometric properties, including reliability and validity.