Historically, surgery for pain has been a large part of general neurosurgical practice. A variety of destructive and decompressive interventions have been developed over the years, and a number of comprehensive textbooks have summarized neurosurgical involvement with management of all kinds of medically refractory pain syndromes. It is included in the core neurosurgical education curriculum and is an integral part of neurosurgical knowledge that is tested during the Oral Board Examination. Not surprisingly, cases involving complex pain conditions that require neurosurgical interventions routinely show up during examinations, and it is expected that examinees are comfortable performing these interventions and able to discuss indications, surgical details, outcomes, and complications. Cases include trigeminal neuralgia, plexopathy, cordotomy versus morphine pain pump for cancer pain, dorsal root entry zone myelotomy for brachial plexus avulsion, and complex regional pain syndrome.