Neuroma pain is one of the most challenging diseases that face the nerve surgeon. Although the surgery is not technically difficult, the prognosis remains reserved due to recurrences. The painful neuroma has to be resected unless it is on a motor nerve with residual function. Once resected, the nerve stump has to be given a target, as the axons will attempt to regrow. Different targets have been used throughout history with variable degrees of success. These include vein, bone, muscle, another nerve, allograft, or a tube. If the primary treatment of the neuroma fails, neuromodulation with nerve stimulation can be considered. More recently targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) are used.