AbstractGanglion impar is a solitary ganglion located retroperitoneally at the end of para vertebral sympathetic chain and usually in front of sacrococcygeal joint. Solitary or metastatic tumour in the surrounding tissues causes poorly localized pain. This is a case of 76 year old male, who was diagnosed to have advanced metastatic adenocarcinoma prostate, presented with pain over the lower back radiating to ano rectal region since last 4 months. He had severe pain during defecation which could not be controlled with conventional high-dose opioid application but with transcoccygeal Ganglionimpar chemical neurolysis. We reasoned that blocking the ganglion impar could attenuate this sympathetically maintained pain, which would lead to a reduction in the consumption of opioids, lessen constipation, and lead to an improvement in the patient’s quality of life.