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Background and Aims Cluster headache is a rare primary headache characterized by strong, unilateral episodes from the vertex or occipital region, having peaks in the retro-orbital and/or temporal areas. Patients often describe the pain as sharp, burning, and stabbing, with an intensity reportedly 100 to 1000 times greater than that of a migraine.Methods A 45-year-old male with cluster headaches for 12 years was referred to the pain clinic by a neurologist due to deteriorating symptoms during the last 10 months. His medical regimen includes Verapamil (Isoptin), Valproate (Depakine) and Aspirin (salospir). His medical history was generally typical. On his initial visit, he reported substantial clinical deterioration, with up to four cluster episodes per day, each lasting 15 minutes to 3 hours. Due to the frequency and intensity of his episodes, he was overusing subcutaneous sumatriptan, consuming up to four doses daily. During the visit, an active cluster episode occurred, necessitating an urgent lesser occipital nerve block using 2 mL of 0.375% Ropivacaine and 2 mL of dexamethasone. The patient reported significant improvement, regarding his NRS pain level dropping from 10/10 to 4/10. This was followed by seven further peripheral nerve block interventions using the same protocol—initially every three days (four sessions), then every two weeks (the last three). During the intervals between blocks, the patient required sumatriptan on only three occasions.Results At six-month follow-up, the patient became free of cluster episodes and utilized a modest medication regimen.Conclusions Peripheral nerve blocks of the head and neck serve as valuable diagnostic and therapeutic tools in headache management. They are effective both for acute pain relief and as a preventive measure in primary headache syndromes, particularly in drug-resistant cases. Interventional pain management techniques continue to expand the treatment options for these challenging clinical scenarios.