Objectives: The 39-item Five Facet Mindfulness Questionnaire (FFMQ) has been used extensively to evaluate mindfulness features that contribute to well-being but assessments of its factor structure and incremental validity have been limited across cultures and clinical populations. The present study was designed to (1) identify the optimal FFMQ factor structure for Chinese adults with chronic pain and (2) evaluate the incremental validity of the best-fitting FFMQ structure in predicting emotional distress, independent of key pain-related correlates of distress. Methods: Participants were Chinese adults with chronic musculoskeletal pain (271 women, 68 men) who completed a back-translated self-report battery that included the FFMQ, measures of demographics, emotional distress, and pain experiences. Results: Confirmatory factor analyses (CFA) indicated the three-factor 12-item version of the FFMQ (i.e., the MQ-12) was the only version to have uniformly acceptable model fits in the sample. Hierarchical multiple regression analyses indicated MQ-12 “describing one’s experience” and “acting with awareness” components contributed an additional R =.05 to R =.21 to the prediction of depression, perceived stress, and pain catastrophizing after controlling for other significant predictors. Across models, acting with awareness was the sole MQ-12 facet to have a unique, statistically significant impact. Conclusions: Findings support use of the MQ-12 in future treatment studies of chronic pain in China and provide foundations for the hypothesis that changes toward improving the acting with awareness facet are especially critical for reducing emotional distress within this group.