Objective: Patients with chronic central neuropathic pain (CNeP) typically report considerable pain that requires frequent health care resource (HR) utilisation. The purpose of this study was to estimate the cost-effectiveness of pregabalin for the management of CNeP in a Canadian practice setting from a Ministry of Health perspective. Methods: A stochastic simulation model was used to determine the effect of adding pregabalin to current treatment on daily pain and associated costs in a hypothetical cohort of 1000 patients with chronic CNeP. The model was based on data from a randomized, double blind, placebo-controlled, parallel-group, multicentre clinical trial of pregabalin, in which pain was evaluated using a 0-10 pain scale. Modeled Outcomes of interest included quality-adjusted life-years (QALYs) and mean number of days with no or mild pain (score =3) over the trial duration of 12 weeks. HR utilisation (including drug costs) was assessed from a survey conducted with a group of 149 Canadian physicians and included number of physician visits, referral to specialists and waiting times, diagnostic tests and non-pharmacological treatments. Corresponding costs were obtained from Ontario Drug Benefit, London Health Sciences Centre, and the Régie de l'Assurance Maladie du Québec, and are expressed in 2007 Canadian dollars. Sensitivity analyses were conducted on model's assumptions. Results: Compared with no additional treatment, treatment with pregabalin yielded a cost-utility ratio of $9648/QALY, and a cost-effectiveness ratio of $10/day with no or mild pain. Sensitivity analyses suggested that resulting ratios were very robust to changes. The most prominent variation reported was for the extension of the time horizon up to 52 weeks, with a cost-utility ratio of $23,087/QALY. Conclusion: Model simulations demonstrate that adding pregabalin to the current pharmacotherapy received by CNeP patients, compared to no additional treatment, is a cost-effective treatment strategy.