Facial pain is a perplexing problem confronting all who practice the healing arts. The purpose of this article is to concentrate on one aspect of facial pain--trigeminal neuralgia. An overview of this entity is presented by demonstrating current concepts in its etiology, diagnosis, and treatment. Classically, trigeminal neuralgia has been described as a paroxysmal, lancinating, knifelike pain which is limited to the anatomic pathways of the fifth cranial nerve. It is a chronic facial pain that is amenable to medical and surgical treatment when correctly diagnosed. A knowledge of the anatomy of the fifth cranial nerve is essential for a correct diagnosis of trigeminal neuralgia. A description of the anatomy is not within the scope of this article, and the reader is referred to any of the standard anatomy textbooks for review.