Pain Peko comes from streams by Usada Pekora, the rabbit-eared VTuber from Hololive known for her loud laughs, pranks and frequent peko speech pattern. Clips of her reacting in pain or disappointment were cut from livestreams and shared across YouTube, TikTok and Discord soundboards, where fans turned her exaggerated sad noises into a reusable reaction. It stayed popular because it works outside Hololive fandom too, instantly signalling cute, over-the-top suffering without needing any context from the original stream.