Purpose of Review <p>The purpose of this review is to provide an update on the efficacy and safety of capsaicin in the treatment of neuropathic pain.</p> Recent Findings <p>Capsaicin can provide prolonged relief from pain in various neuropathies. One proposed mechanism is the ability to cause degeneration of hypersensitized nerve tissue and incite regeneration of healthy nerve fibers. Capsaicin provides more significant relief than placebo and is non-inferior to pregabalin in the treatment of peripheral neuropathy. It is emerging as an alternative but effective and well-tolerated treatment for neuropathy due to diverse pathologic conditions.</p> Summary <p> Capsaicin, a natural agonist at the TRPV1 receptor, has been studied for its therapeutic role in neuropathic pain. Capsaicin is an effective treatment with significant reduction in both diabetic and non-diabetic neuropathic pain. Due to its topical application, it is associated with fewer systemic adverse events and therefore, an attractive option in the treatment of peripheral neuropathy. </p>