In our practice pudendal neuralgia is defined as pain in the area of innervation of pudendal nerve. Pudendal nerve entrapment is compression of the nerve by scar tissue, ligaments, or surgical material. Pudendal neuralgia may be caused by pudendal nerve entrapment, but other conditions described in this manual may lead to pudendal neuralgia. Diagnosis of pudendal nerve entrapment is difficult, and it is often made by exclusion of those other conditions leading to pudendal pain (pudendal neuralgia). Most patients with pudendal nerve entrapment have a traumatic event that causes the onset of pain. Pelvic MRI may be helpful in ruling out other conditions causing pain and CT-guided pudendal nerve blocks narrow down the diagnosis to the pudendal nerve. Conservative treatments include avoidance of nerve reinjury, physical therapy, nerve blocks, and oral medications such as gabapentin or pregabalin. Patients may also benefit from nerve ablation procedures (pulse radiofrequency and cryoablation) and nerve stimulators. For patients who have failed all the conservative treatments, surgical decompression is an option with good outcomes.