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INTRODUCTION: Chronic Widespread Pain (CWP) is a disabling condition with no established cure. As a nociplastic pain condition without active tissue damage, it is considered potentially reversible. Pain Reprocessing Therapy (PRT) is a mechanism-based psychological intervention shown to reduce or eliminate pain in chronic low back pain but has not been tested in CWP. METHODS: This 12-week, two-arm pilot randomized clinical trial enrolled 53 participants with CWP, randomized 1:1 to PRT (n = 27) or psychoeducation control (n = 26). The PRT group received one health evaluation and education session, followed by eight weekly 1-h individual PRT sessions; the control group received four bi-weekly 1-h group psychoeducation sessions. Primary outcomes assessed feasibility, including recruitment, randomization, adherence, dropout, and adverse events. Secondary outcomes evaluated pain intensity, pain interference, anxiety, depression, kinesiophobia, myalgia, fatigue, and health-related quality of life. RESULTS: Over 13 months, 416 individuals were screened, and 53 were enrolled. The PRT group attended a mean of 7.8 sessions. Dropout occurred in 3 (11.1%) PRT and 7 (27.0%) control. Data retention was 85% at 8 weeks and 79% at 12 weeks. Favourable trends for PRT were observed in all secondary outcomes at 12 weeks. CONCLUSION: Preliminary evidence suggested that PRT is feasible and acceptable for patients with CWP, with favourable trends observed in pain reduction, functional outcomes, and psychological well-being. Findings from this pilot study provide practical insights to inform the design of a future large-scale randomized controlled trial, including considerations for sample size, study design, outcome selection, and intervention delivery. TRIAL REGISTRATION: This research study is registered under the Chinese Clinical Trial Registry (Trial Registration Number: ChiCTR2400081418) on 29th Feb, 2024.