Neuropathic pain is challenging to treat, partly because of the systemic side effects of the commonly used medications. Therefore topical analgesics are potentially very usefull. Lidocain, capsaicin, amitriptyline and ketamine have been used topically on a pathophysiological basis and because of their favourable safety profile. Application of lidocain 5%, capsaicin 0.025-0.075% and doxepin 3.3% is effective, although moderately in peripheric neuropathic pain with allodynia and should be considered as a therapeutic option. However, this option should be evaluated on an individual basis. The efficacy of topical amitriptyline and ketamine is not demonstrated.