Headache is the most common complaint everyone experiences in a lifetime regardless of age, sex and race. Most of the times it is managed with rest, assurance and simple analgesics. But persistent headache can be a symptom of serious ongoing medical problem like hypertension, sign of stress, anxiety or psychiatric disorders. It is important and necessary to seek medical checkup and advice if the frequency of headache increases; it becomes more persistent, severe and if associated with neck stiffness or neurological symptoms. There are different causes of headache like sinus headache, migraine, cluster headache, tension headache and headaches associated with trauma or intracranial pathologies. Spondylitis in the cervical spine can also result in neck pain and headache. Occipital neuralgia is one of the causes of headache due to inflammation or injury to the occipital nerves that runs through the scalp resulting in pain over occipital region and neck. It presents with severe paroxysms of burning; shock like pain in the distribution of occipital nerves and often confused with other causes of headache syndromes like migraine or cluster headache. Nerve blocks using local anesthetics are used if no response to conservative treatment.