Ninety-seven patients with cervical facet arthropathy were randomized to receive Cervical Facet Medial Branch Blockade (CMBB) with 1% lidocaine plus 2 mg dexamethasone (n = 49) or 1% prilocaine plus 2 mg dexamethasone (n = 48). The primary outcome of interest was change in pain severity measured by the Numeric Rating Scale-11 (NRS-11). Secondary outcomes included neck functionality assessed by the Neck Disability Index (NDI), patient satisfaction, and adverse effects. Outcomes were assessed at baseline, 1 hour, 1 week, and 1 month post-procedure. Overall, the results of the study revealed that both treatments significantly reduced pain and disability scores at all time points, with no significant differences between groups. These findings suggest that lidocaine and prilocaine offer similar short-term therapeutic benefits in CMBB.