Trigeminal neuralgia and atypical facial pain are common conditions of facial pain. Although these two pain conditions are classically well separated in textbooks, a straightforward diagnosis may not always be possible because of the overlapping clinical signs and symptoms. In this article, a comparison and differentiation between the clinical and diagnostic features of these two pain conditions are presented. The general characteristics, etiologic characteristics, pathophysiology, differential diagnostic criteria, and therapeutic options of trigeminal neuralgia and atypical facial pain are described. A case report demonstrates the difficulties that can arise in the diagnosis and differentiation between the two disease entities. The article underscores the responsibility clinicians have in correctly diagnosing and managing patients with facial pain conditions.