The objective of this study was to assess the natural history of trigeminal neuralgia (TN) and pretrigeminal neuralgia (PTN) in a hospital‐based sample using a retrospective and descriptive study design.

This study followed a retrospective study design, which yielded a sample size of 216 patients who were reclassified as per the new classification and diagnostic grading for practice and research proposed by the American Academy of Neurology. Based on an in‐depth analysis of patient history and the treatments administered, a possible state of PTN prior to TN development was determined.

TN shows a female predilection with predominantly unilateral involvement. A total of 45.83% of patients had left‐side involvement with V3 primarily affected. Additionally, 11.11% of patients did not have any clinically apparent trigger zone, while 68.05% had a single trigger zone. Twenty‐one patients were found to have suspected PTN prior to TN. The time interval between PTN onset and TN development ranged from 6 months to 6 years. The PTN pain varied, and the clinical overlap between the site of PTN and the site of future TN was 100%.

An in‐depth patient history can serve as a reliable modality for TN diagnosis. PTN should be considered as a differential diagnosis for pain of orofacial origin because of its overlapping features with other painful conditions.