Objective: This pilot study was undertaken to test techniques of application of laser therapy, appropriate outcome measures and to determine effect sizes in order to facilitate the performance of a larger, clinical trial of laser therapy in chronic neck pain. Methods: We conducted a randomized double-blind, placebo-controlled study of low level laser therapy in 20 patients with chronic neck pain. The primary outcome measure was change in a 10 cm Visual Analogue Scale [VAS] for pain. Other measures used included a Self-Reported Improvement in pain [SRI], measured by a VAS, Short-Form 36 Quality-of-Life questionnaire [SF-36], Northwick Park Neck Pain Questionnaire [NPNPQ] and the McGill Pain Questionnaire [MPQ]. Measurements were taken at baseline, at the end of 7 weeks treatment and at 12 weeks from baseline. Results: We found a positive, pain-relieving effect in the treated group compared with those given placebo using the VAS [P < 0.039], SRI [P < 0.001], NPNPQ [P < 0.002] and the MPQ [P < 0.009]. The results of the SF-36 did not differ significantly between the two groups. Patients in the treated group experienced an average pain score improvement of 66.7% compared with 16.6% in the placebo group. Conclusion: Low-power laser therapy, at the parameters used in this pilot study, may provide a non-invasive, non-pharmaceutical therapy for chronic neck pain for patients in general practice. Further study of this technique in a large-scale trial would be justified on the basis of the findings of this pilot Study.