Chronic postsurgical pain (CPSP) is defined as persisting for at least three months following surgery, localized to the surgical site or its neural distribution, and not attributable to other causes. CPSP affects 20%–30% of patients postoperatively, with incidence varying by surgical type, reaching up to 85% in amputations and thoracotomies. Risk factors include pre-existing pain, younger age, female sex, high BMI, psychological distress, prolonged or extensive surgery, nerve damage, and severe acute postoperative pain. The pathophysiology involves peripheral and central sensitization, immune responses, and neuroplastic changes. Preventive strategies include regional anaesthesia, multimodal analgesia, and optimized surgical techniques. Epidural analgesia, thoracic paravertebral blocks, and wound infiltration have effectively reduced CPSP risk in specific surgeries. Pharmacological interventions, such as NSAIDs, ketamine, and IV lidocaine, may also help. Management strategies focus on multimodal analgesia, nerve blocks, neuromodulation, and psychological interventions. A multidisciplinary approach, incorporating physiotherapy, cognitive-behavioural therapy, and transitional pain services, is essential for long-term pain control. Given its impact on quality of life and healthcare costs, early identification, prevention, and individualized treatment strategies are crucial in mitigating CPSP.