Clinical neurosensory testing (NST) is currently the gold-standard for the diagnosis of traumatic and non-traumatic peripheral trigeminal neuropathies (PTN) but exhibits both false positive and negative results when compared to surgical findings and frequently delays treatment decisions as the results are dependent upon patients’ subjective responses and observer skill. The use of NST in the diagnosis and prognosis for the management of trigeminal neuropathic conditions will be reviewed. We recently have tested the hypothesis that Magnetic Resonance Neurography (MRN) of PTN can serve as a diagnostic modality similar or better than NST by correlating NST, MRN and surgical findings. Our studies show that MRN anatomically maps PTN and stratifies the nerve injury and neuropathies with moderate to strong agreement with NST and surgical findings for clinical use. The application of a non-invasive objective modality like MRN to determine the classification and characteristics of an injured or abnormal trigeminal nerve earlier than NST can be tested in prospective studies in the future as it could serve as an important technique for outlining treatment decisions and determining patient outcomes. The effects of surgery on peripheral trigeminal neuropathies will be discussed.