Idiopathic trigeminal neuralgia is a common form of facial pain that severely affects the patients’ quality of life. However, treatments for trigeminal neuralgia vary because of the lack of knowledge on its etiological factors and mechanisms. Local drug injection is a useful and minimally invasive technique to manage trigeminal neuralgia easily; this treatment involves a wide range of drugs. This article aims to review the research progress on local drug injection to treat primary trigeminal neuralgia.