This study assesses the incidence of neuropathic pain after orthognathic surgery at our center and briefly reports the cases found. All records of orthognathic surgical patients between 2001 and 2011 were exported from the hospital information system into a Portable Document Format platform (Adobe Acrobat) to simplify keyword searching. Records of patients that developed debilitating chronic pain were isolated and examined. Records included 982 bilateral sagittal split osteotomies, 536 LeFort I procedures, and 335 surgically assisted rapid palatal expansion procedures. Six records were identified that described cases in which patients developed debilitating chronic neuropathic pain after orthognathic surgery (mean age at surgery, 43 years). The exposure of the inferior alveolar nerve or partial axonal injury together with a disruption of the bony environment of the inferior alveolar nerve is a risk factor after bilateral sagittal split osteotomy.