PURPOSE OF REVIEW: Chronic pain affects millions worldwide, reducing quality of life and posing a major healthcare challenge. This review aims to explore advancements in neurosurgical interventions for managing chronic pain, focusing on the latest neuromodulation techniques, and addressing how these innovations may offer alternative solutions for these patients. RECENT FINDINGS: We reviewed advances in high-frequency spinal cord stimulation, dorsal root ganglion stimulation, and closed-loop neuromodulation systems, which optimize precision in pain control and reduce adverse effects. Improvements in targeted drug delivery enabled more accurate and sustained management of pain, with fewer unfavorable effects than traditional therapies. Additionally, we discussed emerging technologies, including artificial intelligence for personalized treatment adjustment, and gene therapy for addressing pain at a molecular level, innovations that also hold promise for future applications. Neurosurgical techniques have the potential to transform chronic pain management, offering improved control with fewer complications. However, challenges remain regarding accessibility, cost, and long-term efficacy. Further research is needed to refine, expand access, and enhance effectiveness.