Chronic neuropathic pain can be challenging to diagnose and to treat, and is thought to cause greater impairment of quality of life compared with other pain syndromes. This chapter defines neuropathic pain, discusses common causes and provides a systematic approach to treatment. Case examples: Chiari-like malformation and syringomyelia; Steroid-responsive meningitis arteritis (SRMA); Intervertebral disc herniation.