Occipital neuralgia (ON) stands out as one of the most distressing forms of headache disorders, distinguished by persistent pain at the base of the skull, recurring occipital headaches, and scalp dysesthesia or allodynia. ON is notorious for its unrelenting agony, severely impacting the lives of those afflicted. The incessant pain, often radiating upward from the base of the skull to the scalp, can be profoundly debilitating. Patients frequently endure excruciating occipital headaches, making even routine daily activities a formidable challenge. The added burden of scalp dysesthesia or allodynia, where seemingly innocuous stimuli elicit severe pain, compounds the suffering. This neuralgia primarily arises from the mechanical compression exerted on the occipital nerves along the nuchal line. In this paper, we present a minimally invasive nerve and muscle-preserving technique aimed at relieving this compression on the occipital nerves. Accurate diagnosis and effective treatment are paramount in providing relief for individuals battling this condition. Nerve blocks with local anesthesia have become a cornerstone of diagnosis, serving as both a confirmation of occipital neuralgia and a potential therapeutic intervention. These procedures offer crucial insights into the source of the pain while offering transient respite. However, the true breakthrough lies in the innovative technique we propose - a procedure that addresses the mechanical compression at the nuchal line, which is a prominent contributing factor to occipital neuralgia. By carefully decompressing the affected occipital nerves while preserving their integrity and surrounding muscle tissue, this minimally invasive approach offers patients a potential path to sustained relief. Remarkably, the procedure can be performed under local anesthesia, reducing the invasiveness of traditional surgeries and minimizing patient downtime.