Saphenous neuralgia is characterized by persistent neuropathic pain at the distribution of the saphenous nerve. Injury to the saphenous nerve, and specifically to its infrapatellar branch of the saphenous nerve has been implicated as a cause of medial knee pain after orthopedic knee surgery or trauma. We present two cases of saphenous neuralgia, one after total knee arthroplasty and the other after anterior cruciate ligament reconstruction, that were adequately treated with ultrasound-guided saphenous nerve blocks distal to the adductor canal. Early recognition and treatment of saphenous neuralgia is essential to prevent persistent disabling pain, which significantly affects patients' quality of life.