Background: Chronic neuropathic pain remains one of the most challenging conditions in clinical neurology, characterized by a complex interplay of peripheral sensitization and central neuroinflammation. Palmitoylethanolamide (PEA), a lipid-derived endogenous fatty acid amide, has gained significant attention for its ability to modulate these pathways via the Peroxisome Proliferator-Activated Receptor Alpha (PPAR-α). Objective: This series reports on the 120-day clinical outcomes, safety, and functional recovery of 30 patients utilizing a branded, high-purity (>98%) PEA tablet (Peaoid®, Aurora Farmabio). Methods: A retrospective analysis was conducted on 30 patients (mean age 54 ± 8 years) suffering from refractory neuropathic pain (Baseline VAS ≥ 6). Patients received one 600 mg Peaoid® tablet twice daily (1,200 mg/day). Follow-up assessments were conducted at 30, 60, 90, and 120 days. Results: Pain reduction was progressive and statistically significant. Mean VAS scores dropped from 7.8 ± 0.6 to 2.4 ± 0.4 at Day 120 (69.2% improvement). Patients also reported a 55% improvement in sleep latency and a 60% reduction in the use of rescue analgesics such as gabapentinoids. Conclusion: The high-purity Peaoid® tablet provides a robust, safe, and cumulative therapeutic effect, positioning it as a cornerstone for long-term chronic pain management strategies. Keywords: Palmitoylethanolamide (PEA), Peaoid, Chronic Neuropathic Pain, Neuroinflammation, PPAR-α Modulation, Pain Management, Analgesic Therapy, Clinical Case Series, Refractory Pain, Neuroprotection.