Abstract: Glossopharyngeal neuralgia (GN) is a rare cause of severe throat pain and odynophagia. It is rarer than trigeminal neuralgia (TN) and is often associated with vascular conflict. While there are well known non-compressive causes of such neuralgias but impact of hyperglycemia in precipitating or exacerbating its symptoms remains under-explored. Here, we present a case of a-67-year-old male who presented with acute, severe odynophagia and painful chewing. He was diagnosed with GN after excluding other possible causes. Investigations revealed poorly controlled diabetes mellitus (DM) and neuroimaging showed a vascular conflict with the basilar artery abutting the glossopharyngeal nerve. Interestingly, the neuralgic episodes were noted to get precipitated by hyperglycemia. Intensive glycemic control alleviated the neuralgic pain significantly. Hyperglycemia can worsen focal demyelination making it hyperexcitable. This case highlights the role of hyperglycemia in precipitating the GN in a patient with a rare vascular conflict. Although, we need large scale studies to prove such association but the rarity of GN is a speed breaker to such executions. Key words: Glossopharyngeal neuralgia, hyperglycemia, trigeminal neuralgia, vascular conflict.