<p>Neuropathic pain (NP) is a subtype of refractory chronic pain that currently presents three major difficulties in diagnosis and therapy in that clinicians must depend on patient complaints for the diagnosis, physicians find it difficult to recognize the disease early, and the evaluation of efficacy is slow. This review surveys the research on NP biomarkers conducted to date and aims to provide a scientific basis and reference for the exact diagnosis and treatment of NP. Studies indicate that the core pathological mechanism producing NP and its changes is the pathological plastic changes which have occurred in the sensory nervous system and that distinct etiologies of NP are associated with unique pathological mechanisms. NP biomarkers exist in such facets of investigation as biochemical, electrophysiological, imaging, genetic and epigenetic studies. Each category of biomarkers can provide specific utility for the diagnosis and prognostic assessment of NP. However, the high heterogeneity of NP limits the clinical translatability of individual biomarkers. Therefore, a multimodal integration of biomarkers is required for NP diagnosis and treatment, utilizing strategies including multicenter clinical research and therapeutic interventions, integrated multi-omics data analysis, to progressively develop an increasingly precise diagnostic and therapeutic system. These efforts will progressively facilitate the transition of the NP diagnostic and therapeutic model from traditional empirical medicine to a data-driven paradigm.</p>