Sixty patients with chronic lower cervical radicular pain refractory to conservative treatments were randomized to receive either ultrasound-guided selective nerve root pulsed radiofrequency (ULSD-SNRPRF; n=30) or fluoroscopy-guided paramedian cervical interlaminar epidural steroid injection (FL-CIESI; n=30). Outcomes assessed included pain intensity (NRS-11), neck disability (NDI), neuropathic pain (S-LANSS), and medication usage (MQS III), evaluated at baseline, 3 months, and 6 months. Procedure duration and adverse events were also recorded. Overall, the results revealed that both interventions significantly improved pain, disability, and neuropathic symptoms without significant differences between groups. The ULSD-SNRPRF procedure took longer, but both techniques were similarly effective and safe. These findings suggest that either method is viable for managing chronic cervical radicular pain, with choice depending on available resources and clinical context.