Cranial nerve blocks are utilized in the diagnosis and management of head and neck pain. While the usual precautions necessary for any local anesthetic injection are taken for these blocks, there are unique safety considerations. Arterial injection of a very small quantity of local anesthetic into a branch of the facial artery, or backflow into the middle meningeal or ophthalmic artery, can still produce seizure or blindness. By inference, embolic stroke is possible if bubbles or particles are injected intravascularly. Muscle anesthesia can produce impaired balance through loss of proprioception. This chapter covers the trigeminal block, sphenopalatine ganglion block, facial nerve block, glossopharyngeal nerve, and spinal accessory nerve.