Trigeminal neuralgia (TN), also known as tic douloureux, is a facial pain syndrome characterized by brief, paroxysmal, intense, lancinating, or shock-like pain in the somatosensory distribution of the trigeminal nerve—the fifth cranial nerve (CN-V). Of the three branches of CN-V, the mandibular and maxillary divisions are affected more often than the ophthalmic. The incidence of TN increases with advancing age, and it occurs most often in the sixth and seventh decades and rarely before the age of 40. TN is more common in females and more frequently involves the right side of the face. The initial treatment of choice of TN is medical therapy which consists of the following options: carbamazepine, oxcarbazepine, gabapentin, lamotrigine, baclofen, phenytoin, topiramate, clonazepam, pimozide, and valproic acid. A short note on surgical treatment of TN has been also provided in this chapter.