In addition to microvascular decompression surgery, there are other methods of trigeminal nerve treatment. Each treatment method has different indications, postoperative results, and complications, and patients are advised to choose correctly. In addition to microvascular decompression surgery, which is currently the main surgical method, there are other less commonly used surgical methods. Destructive surgery, such as radiofrequency destruction of the trigeminal nerve semilunar node, alcohol glycerin and other injection destruction, closure therapy, radiosurgery’s gamma knife, radiofrequency knife trigeminal nerve root destruction, balloon compression, sensory root cut, etc., has excellent early efficacy, but the recurrence rate is increasing year by year. In some elderly patients who cannot tolerate microvascular decompression surgery, or who have recurrence after microvascular decompression surgery, destruction surgery can be performed. Because it is a destruction, the nerve cannot be regenerated and the main complication is loss of facial sensation. In conclusion, younger patients are recommended to define the etiology and perform microvascular decompression surgery with lasting results and without the complications of facial numbness. For older patients, such as those over 75 years old, with poor physical condition and risky surgery and anesthesia, radiosurgery, radiofrequency disruption, and balloon compression can be considered.