We encountered a case in which a combination of venlafaxine and cognitive behavioral therapy alleviated intractable trigeminal neuralgia. The patient was a 72-year-old woman. Despite treatment for trigeminal neuralgia with various types of medications, nerve blocks, and neurovascular decompression, she reported pain that repeatedly flared up. The patient was transferred to our department and received treatment with a combination of venlafaxine and cognitive behavioral therapy. As a result,the pain was alleviated. Chronic pain tends to be intractable due to physical and psychosocial factors; thus, it is important to combine pharmacotherapy and non-pharmacotherapy to achieve effective treatment. Venlafaxine has no indications for pain in Japan; however, it may be efficacious for treating chronic pain.