Aim. To investigate the efficacy of gabapentin phonophoresis for neuropathic pain management in intercostobrachial neuralgia cases. Material and methods. Fifty-seven females with intercostobrachial neuralgia were randomly collected then allocated into two groups, Study group (gabapentin phonophoresis) and Control group (gabapentin gel). Study group: received gabapentin phonophoresis 4 times/week for 4 weeks (a total of 16 sessions) using continuous ultrasound (1 MHz, 1.5 W/cm2, for 5 minutes). Control group: received topical 6% w/w gabapentin gel three times per day for 4 weeks on the affected site. The methods of assessment included visual analogue scale (VAS) and Neuropathic pain scale (NPS). All measurements were collected before the beginning of the study and after the end of the treatment (after 4 weeks). Results, There was no significant difference between both groups in VAS (= 0.43) and NPS (= 0.46) pre-treatment. Comparison between groups post treatment revealed a significant decrease in VAS and NPS of study group compared with that of control group (p < 0.001). The percentage of decrease in VAS of study group and control group was 51.32% and 43.03% respectively while the percent of decrease in NPS was 50.79% and 45.05% respectively. Conclusion, It was concluded that conduction of gabapentin gel topically or by using phonophoresis is safe and effective method for neuropathic pain management and can alleviate pain intensity; however, phonophoresis achieved better results and was superior to traditional gel application.