The Conus venom is secreted by the duct and theca of venom. Most of conotoxins are composed of 10-40 amino acid residues with several disulfide bridges. They can specifically target neurotransmitter receptors including nAChRs, calcium ion channels, sodium ion channels and potassium ion channels, etc. Some conotoxins, such as that target N-Ca2+ channels, nAChR alpha9alpha10 subtype, TTX-R Na+ channels or NMDA receptors, have potent antinociceptive activities, omega-MVIIA, an Ca2+ channels blocker was approved by FDA in December, 2004 for marketing. Because of lower molecular weight and high specificity, conotoxins are the powerful pharmacology tools and potent analgesics without addiction. This review briefly summarizes the research progress of antinociceptive conotoxins and addresses on their targets and structure-activity relationships.