Nasal endoscopy is a valuable adjunct to the localization of the sphenopalatine ganglion. Twenty-two patients with advanced malignancies of the head and neck region whose pain was not adequately controlled with conventional medications, including oral morphine, were given nasal endoscopically guided neurolytic sphenopalatine ganglion block with six per cent phenol after a prognostic block with local anaesthetic solution. Seventeen patients had good immediate relief. One had partial relief and four had inadequate relief. On follow-up for one month, the patients had significantly lower pain intensity and the pain was more manageable with oral medication. The vicious cycle of pain was broken. This block is relatively safe and can be usefully performed as an out-patient procedure.