Objective To further evaluate the efficacy and safety of computerized tomography–guided sphenopalatine ganglion–targeted pulsed radiofrequency treatment for patients with refractory episodic and chronic cluster headache (CH). Methods Forty‐five patients with refractory episodic CH and 14 patients with chronic CH who underwent computerized tomography–guided sphenopalatine ganglion–targeted pulsed radiofrequency between January 2011 and December 2018 at the Beijing Tiantan Hospital were included and analyzed in this retrospective cohort study. Results A total of 59 patients underwent 106 computerized tomography–guided pulsed radiofrequency procedures throughout the observational period. Effective remission was observed in 95.6% and 64.3% of patients with refractory episodic and chronic CH, respectively. Repeated computerized tomography–guided sphenopalatine ganglion–targeted pulsed radiofrequency procedures for recurrent CH was also proven to be effective. No severe side effects or complications were observed in this study. Conclusion The computerized tomography–guided sphenopalatine ganglion–targeted pulsed radiofrequency procedure is an effective, safe, and repeatedly effective strategy for refractory CH. For patients who have not responded to conservative treatment, this minimally invasive intervention is a reliable alternative.