Management of brachioradial pruritus (BRP) presents a formidable challenge to dermatologists and neurologists. BRP is a rare, neurocutaneous condition characterized by sharply localized, chronic pain with associated itching, burning, stinging, and or tingling sensation. Effective care of this patient population is confounded by limitations within the literature, comprised of case series and case reports. We present a case of one middle-aged female with a chronic history of BRP recalcitrant to the following oral therapies: pregabalin, gabapentin, mirtazapine, prednisone, and amitriptyline, as well as topical triamcinolone. After being evaluated in the clinic, the patient was started on combination therapy withKetamine 10%, Amitriptyline 5%, and Lidocaine 5% topical cream to which she responded.