Erythromelalgia is a rare chronic disorder characterized by intense burning pain, redness, swelling and increased skin temperature. It occurs primarily in the feet, but may also involve the hands, face and ears. Warming of the extremity or placing and maintaining the extremity in a dependent position can exacerbate symptoms. These symptoms are typically refractory to various medications, but are relieved by elevation or exposure to cold. Although a specific therapy is not available for erythromelalgia yet, several treatment modalities may be used as therapeutic options, including: aspirin, indomethacine beta-blockers, calcium channel antagonists, misoprostol, diltiazem, tricyclic antidepressants, serotonin reuptake inhibitors and number of more aggressive procedures such as intravenous lidocaine, epidural anaesthesia, intrathecal opiates and sympathetic ganglion blockade. There are very few reports in the literature of gabapentin successfully treating erythromelalgia. Here, the authors report a case of primary erythromelalgia in a 20-year-old woman responding to gabapentin therapy.