Eagle syndrome (ES) is a condition characterized by the elongation of the styloid process, leading to neuralgia and vascular symptoms. Conservative management plays a vital role in the treatment of ES, particularly for patients on the surgery waiting list, those at high anesthetic risk, or those opting for non-surgical interventions. Conservative approaches include pharmacologic treatments, local injections, and physical therapies, tailored to reduce pain and improve quality of life in affected individuals. Pharmacologically, first-line treatments for ES primarily involve non-steroidal anti-inflammatory drugs (NSAIDs), which alleviate inflammatory symptoms. Anticonvulsants, antidepressants, and muscle relaxants may be employed for neuropathic pain, often using drugs such as carbamazepine, gabapentin, and duloxetine. If first-line medications prove insufficient, second- and third-line options include opioids and serotonin reuptake inhibitors, offering additional relief. Recent studies highlight the effectiveness of these therapies, with significant improvements in pain reduction and patient well-being. Local treatment options like stellate ganglion blocks and ultrasound-guided injections of steroids or anesthetics have also demonstrated success in managing symptoms. The stellate ganglion block, performed under image guidance, provides targeted relief by numbing the sympathetic nerves responsible for pain, while steroid injections in the tonsillar fossa offer localized inflammation reduction. These methods are particularly useful for patients who are not candidates for surgery or prefer to delay surgical intervention. Other non-pharmacologic treatments, including physical therapy and behavioral therapy, have also been employed. Manual therapy interventions, combined with exercises targeting neuromuscular control, have helped alleviate craniocervical pain in some cases. Behavioral approaches, such as patient education and anticoagulation therapy, are especially beneficial in cases where ES causes vascular complications, like carotid artery dissection. In summary, conservative management is crucial in the comprehensive treatment of Eagle syndrome, offering relief to patients and improving outcomes, especially when surgery is not immediately feasible or desired.