This research assesses the effect of listening to preferred music on pain, depression and anxiety in older care home residents. One hundred and thirteen participants were randomly allocated to either an experimental or a control group. The former, in addition to their usual routine, listened to a daily 30-minute programme of preferred music over a three-week period. Weekly assessments, using validated measures with some adaptations, evaluated levels of pain, depression and anxiety, each a common disorder in this population. The two groups then crossed over, thus enabling all participants to receive the potential benefits of the music intervention. Results showed statistically significant decreases for each dependent variable with the size of the effect being greater for depression and anxiety than for pain. There were no significant improvements for those in the control group. Additional analysis identified variables that either facilitated or limited the benefits of the music. Those with severe pain were unable to benefit, but those who regarded music as important, listened frequently and whose preferences were accommodated benefited to a greater degree than others. It was concluded that listening to preferred music may benefit many members of the care home population although not all will benefit to the same degree.