“Microvascular decompression has become the standard of care for trigeminal neuralgia. Its advantage is that it can release local vascular compression while preserving the integrity of trigeminal sensory transmission and without loss of facial sensation. Microvascular decompression was first proposed by Prof. Jannatta in 1967, and later Haines et al. conducted a more in-depth anatomical study of the relationship between the trigeminal nerve and microvessels and found that 92.5% of cases with trigeminal neuralgia presented with symptoms of trigeminal neuralgia in the presence of microvascular compression of the trigeminal nerve root in the pontocerebrum. Trigeminal nerve manifestation microvascular decompression is the surgical procedure of choice for primary trigeminal neuralgia and is currently the only procedure that can cure trigeminal neuralgia radically. Under general anesthesia, a 4-cm incision is made behind the affected ear along the hairline, the skin and muscles are retracted to reveal the mastoid root, and a 3-cm diameter bony window is drilled. The dura mater is cut and the cerebrospinal fluid is aspirated under the microscope, the arachnoid is cut and the trigeminal nerve root is explored, and the responsible vessels (one or more) that are compressing the trigeminal nerve root are found, including the superior cerebellar artery and its branches (in case of compression by the rock vein, the rock vein must be (in case of rock vein compression, the rock vein must be dissected). The responsible vessels are freed by microdissection and then padded with tefflon surface. The procedure is minimally invasive and has a good prognosis. The vast majority of patients have immediate postoperative pain resolution and retain normal facial sensation and function without affecting quality of life. Except for patients who cannot tolerate surgery, all other patients with trigeminal neuralgia are suitable for microvascular decompression surgery. The most common surgical complications include hearing loss and facial sensory loss, but with the improvement of microsurgical techniques, the incidence of these complications is low in large neurosurgical medical institutions, and except for hearing loss (incidence of about 1%) which is more difficult to recover, most of the symptoms of cerebral nerve injury are mild and more The symptoms of most brain nerve injuries are mild and can be gradually recovered.