This article reports on 450 consecutive patients with occipital myalgia-neuralgia who were treated by percutaneous radiofrequency denaturation into the greater occipital nerve territory. The primary objective of treatment was to alleviate pain originating at the head-neck junction and pain radiating into the occipital nerves' distribution without causing sensory deficit. Follow-ups of two to 10 years revealed permanent relief of occipital pain in about 85% of the patients.A retrospective study of 211 patients undergoing cervical disk and interbody fusion surgery for the relief of persistent neck-shoulder-arm pain with occipital headache showed that 52% obtained complete relief from their headaches. A limited number of cases treated with radiofrequency neurotomy to the facet joints had a success rate of over 50% in relieving or reducing the occipital headache and neck pain.