A case of painful traumatic neuroma, arising from the inferior alveolar nerve after sagittal osteotomy of the mandible with demonstrable radiological change, is reported. The co-existence of temporomandibular joint (TMJ) pain-dysfunction syndrome and a painful traumatic neuroma had posed diagnostic problems. Some modifications of the surgical technique are discussed with a view to minimizing damage to the inferior alveolar nerve during sagittal osteotomy of the mandible. The aetiology, clinical features, diagnosis and treatment of traumatic neuromas are reviewed.