Patients with trigeminal neuralgia whose symptoms cannot be controlled by long-term medication or who cannot continue to receive medication because of the toxic effects of high-dose medication account for approximately 20% of all patients, and patients with refractory trigeminal neuralgia should generally prefer microvascular decompression of the trigeminal nerve. This type of minimally invasive radical surgical procedure (Microvascular Decompression, MVD) was proposed by Dr. Jannetta in 1970 and has been continuously improved by others and has been perfected. Currently, MVD surgery uses microsurgery, endoscopic assistance, locking holes, electrophysiological monitoring, responsible vascular identification and other improved techniques, which have greatly improved the cure rate and safety of this surgery. However, there are still some elderly patients with trigeminal neuralgia who are reluctant to undergo MVD due to their advanced age and frailty, hypertension, coronary heart disease, diabetes, sequelae of cerebrovascular disease or fear of craniotomy, but they can still choose other treatment methods including radiofrequency, balloon compression, drug closure, radiosurgery and other treatments according to their conditions. In October 1985, I was sent to Qingdao to study “radiofrequency treatment for trigeminal neuralgia” with Professor Meng Guangyuan by the leadership of Shan Medical Hospital and Director Zhang Cheng. Due to Professor Meng’s careful guidance and more operation opportunities, I initially mastered the treatment method. Since then, I started to carry out “radiofrequency treatment of trigeminal neuralgia” in the outpatient clinic of the Affiliated Hospital of Shandong Medical University. This medical technology, like other surgical operations, is “easy to see and difficult to do”. In fact, it is not easy to achieve “precise target location” in “anterior approach foramen ovale perineurysis”. Although I have nearly 20 years of clinical experience after graduating from university, I still encountered many difficulties in using the free hand anterior approach to puncture the foramen ovale. There are many important nerves and blood vessels around the foramen ovale, the Meckel’s bursa in the skull, and important anatomical structures such as the internal carotid artery and cavernous sinus in the vicinity, so this operation must be performed with great care and caution. In order to master the method of precise perforation of the foramen ovale, I went to the “Human Anatomy Department” of Shandong Medical University for many times to seek advice from the teachers, and also went to the anatomy laboratory for many times to observe and measure the data and variation of the skull specimen, skull base structure and foramen ovale. At the same time, I wrote many letters to Prof. Meng Guangyuan and Prof. Qian Jie to learn their clinical experience and the design and production principle of foramen ovale locator. In December 1987, I was sent to Utah State University Medical Center as an exchange scholar. During my stay at the University of Utah, I conducted experimental research on nerve cell transplantation in the laboratory while visiting the wards and operating rooms to participate in the ward visits and various surgeries. I was particularly interested in the treatment of “intractable trigeminal neuropathy” by American doctors. According to my observation, American doctors generally adopt surgical craniotomy for patients with secondary trigeminal neuralgia or young patients with primary trigeminal neuralgia to remove the intracranial lesion or isolate the trigeminal nerve root from the responsible blood vessel with Teflon, which is called microvascular decompression. Partial trigeminal nerve root dissection (Daddy’s and Frazier’s procedures) has been rarely performed in individual patients. Radiofrequency thermocoagulation of the trigeminal nerve is the first option for older, frailer, and more elderly patients. Doctors at the University of Utah Hospital typically book two patients per week, perform target localization under an x-ray screen, and then take skull base films to confirm that the target is correct before performing radiofrequency thermocoagulation. Usually the patients are treated very smoothly and with reliable results. However, we sometimes encountered difficult cases where the puncture was difficult and the radiofrequency puncture needle was difficult to enter the foramen ovale, and the doctor was equally nervous and anxious and sweating. In 1989, after I returned to China from the United States, I used the domestic radiofrequency treatment instrument to treat 156 patients with intractable trigeminal neuralgia in the outpatient clinic, with satisfactory results and no serious complications, drawing on the operating methods and experiences of American doctors. I attended the first academic meeting and read a paper on “Preliminary experience of radiofrequency treatment of trigeminal neuralgia”, and was elected as a member of the Pain Branch of the Chinese Medical Association and became a founding member of the society. In September 1990, I invited Professor J. Smith of the Medical College of Georgia (MCG) to visit our hospital and demonstrate epilepsy surgery. During this period, he found that the radiofrequency instrument we were using was rather rudimentary, and he kindly offered to give us a radiofrequency instrument (Radionic) that he had purchased personally. Since then, we have an imported RF instrument and two domestic RF instruments to better serve our patients. The number of patients continues to increase, the treatment is reliable, and we have received a large number of letters of appreciation from patients, especially the old and frail patients or patients who do not want to open surgery, or patients with trigeminal neuralgia who can not afford the expensive cost of gamma knife. By 2000, we had treated 1109 cases of trigeminal neuralgia, and in 2007, we were the first in China to carry out the treatment of intractable trigeminal neuralgia with the radio-wave knife, which added another avenue to the treatment of trigeminal neuralgia. In order to explore the precise location of the anterior approach to the foramen ovale semilunar ganglion target, we used advanced high-tech equipment three-dimensional CT (3D-CT) and nerve navigation positioning system to guide or verify the precise target of the foramen ovale semilunar ganglion, which combined the radiofrequency treatment technology with modern electronic computer imaging technology. This preliminary research result, which was valued by the medical community, was published in Chinese Journal of Neurosurgery, Chinese Journal of Pain Medicine, Chinese Journal of Medicine (English version) and Clin J Pain, and won the second prize of scientific and technological progress of Shandong Provincial Education Department in 2001, and 5 SCI-indexed papers were published successively. In December 2007, the number of patients treated with radiofrequency for trigeminal neuralgia in our hospital has reached more than 2700 cases, and the efficiency of the operation is more than 95%. I have been invited to Shanghai, Xi’an, Fujian, Shenzhen, Kunming, Henan, Shanghai, Hebei, Jiangsu, Xinjiang and many hospitals in our province to visit and consult and demonstrate the operation and treatment of patients, so that this technology can be promoted for the benefit of patients. In mid-May 2008, Prof. Wilson Poon of the Chinese University of Hong Kong invited me to attend the “Hong Kong and Australia Joint Scientific Conference”. At the conference, I presented a paper on “Radiofrequency Treatment of Trigeminal Neuralgia” and received the medal of “Outstanding Scientific Contribution” from the Royal Australasian College of Surgeons. In conclusion, radiofrequency treatment of trigeminal neuralgia still has good therapeutic effect in some patients, and the above is my experience of treating trigeminal neuralgia with this method for more than 20 years.