Erythromelalgia is a condition characterized by intense burning pain, redness, and heat in the extremities that has garnered increasing attention in recent years. This literature review provides a comprehensive historical perspective and current update on primary erythromelalgia or PEM, categorizing and tracing the clinical knowledge of the condition and identifying key milestones of historical research. In a sequential fashion, the review explores the evolution of understanding of PEM, starting from its initial descriptions in the medical literature to the present day. Early case reports and pivotal studies that contributed to recognizing and characterizing the disorder are examined. Important discoveries, diagnostic criteria, and therapeutic approaches that have shaped the management of erythromelalgia over time are highlighted. Additionally, the impact of genetic studies and molecular investigations on current understanding of PEM is discussed. Identifying mutations in the SCN9A gene is emphasized as a significant breakthrough, shedding light on the role of sodium channels in the disorder's pathogenesis. Overall, this review consolidates the wealth of clinical knowledge and research milestones related to PEM. Integrating historical research milestones offers a comprehensive overview of the condition, from early descriptions to the current state of knowledge. This knowledge serves as a foundation for further research and can assist in improving diagnosis and management strategies for individuals with PEM.