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Background and Aims Temporomandibular joint (TMJ) dysfunction is common, with a greater prevalence in females. Hydro dissection, a minimally invasive technique involving injection of fluid to separate fascial layers and release entrapped nerves and tendons, has emerged as a potential treatment. Its use in TMJ pain has not been reported.Methods We present a case series of six patients with refractory temporomandibular joint pain. Despite extensive conservative therapies, including medications and physical therapy, Patients continued to experience TMJ pain. The adult patients (6, mean age 54 yrs) underwent ultrasound-guided masseter muscle hydro dissection as a targeted approach to address perineural inflammation and nerve entrapment. Hydro dissection of the masseter muscle superficial and deep layers was performed on the symptomatic side. A low concentration (5%) dextrose solution was used to free the tendons from surrounding scar tissue and muscle adhesions. The procedure was performed in a theatre setting. Botulinum toxin 50 iu was also used.Results Following the hydro dissection procedure, the patients experienced improvement in Temporomandibular joint pain, with sustained improvement over two months, at follow-up. Functional outcomes, including range of jaw motion and daily activities, improved substantially. No complications were reported.Conclusions This case series supports the potential role of dextrose hydro dissection as a safe, minimally invasive treatment option for TMJ pain. Hydro dissection offers an alternative to more invasive interventions and warrants further investigation in the management of TMJ pain.