Treatment of neuropathic pain is an ongoing challenge for clinicians. In this clinical summary, Dr. Yi Pan and Dr. Florian P Thomas of St. Louis University summarize pharmacological management based on published clinical trials. Not all medications mentioned in this summary have been investigated in placebo-controlled, double-blind, randomized trials. A new guideline for treating painful diabetic neuropathy was published in 2011. The aim of this summary is to provide a variety of updated information for clinicians to choose an optimal treatment for an individual patient.