Abstract This article reports a case of palatal neuralgia treated with transoral endoscopic minimally invasive palatine minor nerve section. A 38-year-old male patient presented with recurrent pain in the left soft palate and superior tonsillar fossa for 4 years. He had been misdiagnosed as pharyngitis, elongated styloid process, glossopharyngeal neuralgia, etc., and failed multiple treatments. The diagnosis of palatine minor neuralgia was confirmed by palatal foramen region block therapy. Transoral endoscopic nerve section was performed, leading to immediate pain relief. Six-month follow-up showed no recurrence and significant improvement in quality of life. This procedure offers advantages such as precise localization, minimal invasion, and no surface scars, providing a new reference for the treatment of palatal neuralgia.