Ｏｂｊｅｃｔｉｖｅ　To investigate the clinical efficacy and safety of the combined therapy of pulsed radiofrequency (PRF) and pudendal nerve block (PNB) in pudendal neuralgia patients. 　Methods　Eighty patients diagnosed with pudendal neuralgia were randomly divided into a PRF＋PNB group and a PNB group. The PRF＋PNB group underwent both PRF and PNB, while the PNB group received PNB alone. All the patients were followed up to evaluate the Visual Analog Scale (VAS) scores and the Patient Health Quwstionnaire-9 (HPQ-9) scores on the postoperative 1, 14, 30 d and 90 d after surgery. All the surgical complications were recorded.　Results　A total of 77 patients were followed up, including 39 patients in the PNB group and 38 patients in the PRF＋PNB group. On the 1 d after surgery, both groups presented remarkably reduced VAS scores compared with pre-operative levels (P<0.05), without statistical difference between the two groups(P>0.05). However, compared with the PNB group, the PRF＋PNB group showed marked decreases in the VAS scores on 14, 30 d and 90 d after surgery(P<0.05). Furthermore, the PRF＋PNB group showed marked lower HPQ-9 scores than the PNB group (P<0.05) in 90 d after operation. The 90 d effective rate was 92.1% for the PRF＋PNB group and 35.9% for the PNB group. No severe adverse events were observed in either group. 　Conclusions　Compared with PNB treatment alone, the combined therapy of pudendal nerve PRF and PNB is effective to relieve pain in patients with pudendal neuralgia in a longer period of time and improve patients′ depression symptoms, without postoperative adverse events.