Trigeminal neuralgia is a transient, recurrent paroxysmal pain in the distribution of the facial trigeminal nerve. It manifests as a burning, stabbing, cutting or tearing pain in the affected face. The pain does not usually go beyond the midline. Each attack may last from a few seconds to 1-2 minutes and then stop abruptly, with intervals as normal. The condition may gradually worsen and the number of pain attacks may become more frequent, even once a few minutes, so that it may last all day. The pain can be triggered by touching the skin of the patient’s face. In severe cases, patients dare not wash their faces, brush their teeth or even chew, and rely on a small amount of liquid or semi-liquid food to maintain nutrition throughout the day, which seriously affects the quality of life. A variety of causes can lead to trigeminal neuralgia, such as: vascular compression, tumor, multiple sclerosis, etc., among which vascular compression is the most common factor. Currently, there are various treatment options for trigeminal neuralgia, which is the most effective? The most minimally invasive? Theoretically, the most effective treatment should be directed at the cause of the disease. Since there are not many treatment options for multiple sclerosis, and since not many patients have trigeminal neuralgia as a result, we will not discuss them here. Instead, trigeminal neuralgia due to both vascular compression and tumor may be completely cured by surgically releasing the nerve compression! So, the next question is how to make this surgery “minimally invasive” to the extreme! With the current level of development of neurosurgical equipment and technology, although the surgeon is not yet able to achieve 100% safety and effectiveness, in most cases, it is possible to decompress the trigeminal nerve sufficiently under the microscope without causing new nerve dysfunction. The patient’s skin incision is only about 50px long and the skull bone hole is about 50px in diameter, which is generally acceptable. Satisfactory tumor resection and neurological decompression can also be obtained for most tumors at the same level of trauma as for dominant microvascular decompression if it is due to tumor compression. Therefore, worldwide, manifest microvascular decompression has become the surgical option of choice for the treatment of trigeminal neuralgia in recent years.