Dry needling is the most expanded intervention for the management of myofascial pain (Dommerholt & Fernández-de-las-Peñas, 2013). The application of trigger point (TrP) dry needling is based on the rational that TMD pain can be related to myofascial TrPs. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) includes the following myalgia diagnosis: local myalgia, myofascial pain and myofascial pain with referral (Schiffman et al, 2014). There is a clear analogy between the diagnosis of myofascial pain with referral and myofascial TrPs (Simons et al. 1999). In fact, there is some evidence suggesting that myofascial TrPs are present in patients with TMD pain (Fernández-de-las-Peñas et al., 2010). This lecture will discuss the role of TrPs in the masticatory muscles and TMD pain and the application of TrP dry needling following a proper clinical reasoning. Several systematic reviews and meta-analysis have found that TrP dry needling may be effective for the management of different pain conditions of the upper quadrant (Boyles et al., 2015; Liu et al., 2015; Gattie et al., 2017); however, it is important to consider that dry needling should be applied in combination with other interventions, and not just as an isolated therapeutic approach (Liu et al 2017). The effectiveness of a multidisciplinary manual therapy program including TrP dry needling for TMD has been reported (González-Iglesias et al 2013; Butts et al., 2017). In fact, no significant differences between TrP-DN and lidocaine injection at short- and mid-term follow-up periods were found confirming that the therapeutic effect is related to the needle and not to any particular substance.