Neuropathic pain is a complex and multifactorial condition resulting from lesions or diseases affecting the somatosensory system, characterized by persistent pain that is often resistant to conventional treatments. Its pathophysiology involves a combination of peripheral and central mechanisms, including ectopic impulse generation, peripheral and central sensitization, ion channel dysfunction, and neurotransmitter imbalance. These processes lead to increased neuronal excitability and maladaptive plasticity, contributing to the chronicity of pain. Clinically, neuropathic pain is classified as peripheral or central depending on the location of the lesion and is associated with conditions such as diabetic neuropathy, postherpetic neuralgia, radiculopathy, chemotherapy-induced neuropathy, and spinal cord injury. Patients typically present with spontaneous pain described as burning or electric sensations, as well as evoked pain such as allodynia. Diagnosis relies on clinical evaluation supported by validated tools and complementary studies, including electrophysiology and imaging. Management is guided by a stepwise and individualized approach aimed at reducing pain, improving function, and enhancing quality of life. First-line treatments include gabapentinoids, tricyclic antidepressants, and serotonin–norepinephrine reuptake inhibitors, while second- and third-line options include topical therapies, opioids, and interventional procedures. Anesthetic agents such as lidocaine and ketamine, along with neuromodulatory drugs, play an important role, particularly in refractory cases. Despite available therapies, treatment outcomes remain suboptimal due to limited efficacy and adverse effects. Emerging strategies, including precision medicine, targeted ion channel therapies, and neuromodulation techniques, offer promising avenues for improving long-term management and patient outcomes.