Postherpetic neuralgia (PHN) remains one of the most troublesome common chronic neuropathic pain conditions. Many controlled trials have been published showing good efficacy and reasonable tolerability. These include gabapentinoids, opioids, tricyclic antidepressants, and topical lidocaine and capsaicin. Combination therapies are possible, but have not been proven, and long-term follow-up is limited. Only few case series exist for surgical and other invasive therapies and their role remains uncertain.