Ketogab Ointment is a topical formulation combining Gabapentin (8% w/w), Capsaicin (0.035% w/w), Ketoprofen (5% w/w), and Methyl Salicylate (5% w/w) designed for the management of localized neuropathic and musculoskeletal pain. Gabapentin, an anticonvulsant with analgesic properties, modulates calcium channels to reduce neuronal excitability and alleviate neuropathic pain. Capsaicin, a natural alkaloid derived from chili peppers, acts by desensitizing sensory neurons through depletion of substance P, thereby diminishing pain transmission. Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), inhibits cyclooxygenase enzymes, reducing prostaglandin synthesis and providing anti-inflammatory and analgesic effects. Methyl salicylate, a topical counterirritant, produces a warming sensation that distracts from deeper musculoskeletal pain and enhances local blood flow. The synergistic combination in Ketogab Ointment offers multi-modal pain relief targeting both inflammatory and neuropathic components of pain. It is indicated for conditions such as peripheral neuropathy, osteoarthritis, muscle strains, and localized soft tissue injuries. Application should be limited to intact skin and avoided on open wounds or mucous membranes. Patients should adhere to recommended dosing to minimize the risk of local irritation or systemic absorption. Ketogab Ointment provides an effective, targeted approach for managing complex pain syndromes with improved tolerability compared to systemic therapies.