Trigeminal neuralgia is a common functional disorder of the nervous system in middle-aged and elderly people, characterized by episodes of severe pain on one side of the face, and the severe pain is often unbearable for patients, which is called the “world’s first pain”. Some patients do not understand the effective treatment of this disease, and often take some detours. Here I will briefly introduce several formal treatments for trigeminal neuralgia. 1, drug treatment: carbamazepine is the drug of choice, with high efficiency. The next choice is oxcarbazepine or other anti-spasmodic drugs. However, with the development of the disease, the efficacy of drug treatment often gradually decreases, the dose of drugs gradually increases, and some patients cannot tolerate the side effects of drugs, such as dizziness, drowsiness, constipation, ataxia and so on. If the above situation occurs, surgical treatment should be considered. 2.Destructive surgery: The main principle is to destroy the nociceptive nerve fibers of the trigeminal nerve through the technique of percutaneous puncture, using radiofrequency, glycerol injection, balloon compression and other methods to block the nociceptive conduction and achieve the purpose of pain relief. Radiofrequency disruption of the trigeminal nerve hemianopsia by percutaneous puncture is the most used. Although this surgical method is less invasive, safe and has a very high efficiency in the near future, the long-term efficacy is not good, and most patients relapse during the follow-up period and need to be treated again. 3. Microvascular decompression: This is the best and most durable surgical method at present. It is reported that its 10-year efficiency (pain disappearance and without drugs) can reach 70-80%. The pathogenesis of trigeminal neuralgia is still not fully understood, but most trigeminal neuralgia is due to vascular compression of the trigeminal nerve root. Trigeminal nerve microvascular decompression is based on this mechanism, and the trigeminal nerve root is exposed through a small bone window minimally invasive craniotomy to release the compression of the nerve by blood vessels, thus achieving the purpose of radical treatment. The biggest difference between this surgery and other surgeries is that this surgery is the treatment for the cause, so its surgical efficacy is also the best. 4, stereotactic radiosurgery: mainly refers to the gamma knife. It is the use of high-dose gamma rays convergence on the trigeminal nerve root to achieve the purpose of treatment, this treatment is non-invasive, safe, does not require craniotomy, but the efficiency of surgery is worse than microvascular decompression, and the pain relief after treatment takes several months, mainly for the elderly, the physical state does not allow craniotomy, surgery failure, relapse, with multiple sclerosis and other cases.