An 8-week, double-blind, vehicle-controlled study was conducted to determine the effectiveness of topical capsaicin 0.075% cream in relieving pain associated with diabetic neuropathy. Patients were selected who experienced moderate to very severe pain, which interfered with sleep or activities on a daily basis, and who were unresponsive or intolerant to conventional therapy. The results after 8 weeks showed a statistically significant difference in favor of the capsaicin-treated patients, with 90% of these patients improved. The results of this study indicate that topical capsaicin 0.075% cream is safe and effective in managing painful diabetic neuropathy.