Otolaryngology practice encompasses the most densely enervated and neurologically interconnected region in the body. Pathology in one area can manifest as pain or other symptoms in others. Some of the most challenging patients present with atypical pain that defies lesion identification and which requires treatment by manipulation of neural physiology itself. Nerve blocks of specific sensory and parasympathetic pathways can help to resolve diagnostic conundrums and focus therapy on a site of lesion or can reduce baseline discomfort. Simple topical nerve blocks can abort migraine episodes and injections of Botox can prevent headaches for months. In this lecture we will explore the physiology of the trigeminal and upper cervical nerves and learn how interrupting transmission temporarily from individual branches can bring relief to many of our patients. We will review anatomy and technique for blocks of the supraorbital and supratrochlear nerves, V2, preauricular, and occipital nerves and the sphenopalatine ganglion. Injection sites and technique of Botox injection will also be reviewed.