Neural prolotherapy, as developed by Jon Lyftogt, has been found to be an effective treatment for neurogenic pain syndromes. We report a case of trigeminal neuralgia successfully treated with neural prolotherapy. The patient is a 70-year-old man with a 15-year history of trigeminal neuralgia refractory to pharmacologic treatment. After one treatment of neural prolotherapy the patient reported 5 months of complete resolution of his symptoms. A second treatment was performed affording him another 10 months of relief. Neural prolotherapy may have an important role in treating trigeminal neuralgia. It can be a safe and effective treatment for those experiencing side effects from medications, contraindications to surgery, or less than favorable improvement from traditional treatments.