Glossopharyngeal neuralgia is a rare craniofacial pain syndrome that consists of paroxysmal pain of the posterior tongue and pharynx, tonsillar fossa, and angle of the mandible triggered by chewing, coughing, yawning, or swallowing. The initial step in treating glossopharyngeal neuralgia consists of oral medication. The pharmacologic approach commonly involves carabamezepine, gabapentin, pregabalin, and phenytoin. Percutaneous nerve blocks with local anesthetics or neurolytic agents may provide relief in some patients. Medically intractable pain may require surgical intervention to treat the underlying vascular compression that is the most common etiology of glossopharyngeal neuralgia. Additionally, some patients may actually require sectioning or a rhizotomy of the ninth cranial nerve. More recently, recurrent and refractory glossopharyngeal neuralgia pain may be relieved with radiosurgery or gamma knife therapy. Because the radiosurgical experience is limited, open microsurgical decompression still remains as the most effective operative mode of therapy.