Zhang Dabu, who lives in the city, had intermittent pain on his left side of the face for the last 2 years, and sought medical help everywhere. He finally went to a private clinic, where he was considered to have periodontitis and had one tooth extracted, which did not work. After consultation, Dr. Huang Qingjiu, the chief physician of our department, considered it as trigeminal neuralgia and performed trigeminal nerve root microvascular decompression. Trigeminal neuralgia is the most common neurological disease of the brain, mainly manifested by severe pain in the distribution area of the trigeminal nerve in the face, also known as painful convulsions. The incidence of trigeminal neuralgia in China is 52.2/100,000, with slightly more women. It mostly starts in middle age and increases with age. The pain is unilateral, mostly on the right side, and rare bilaterally. The etiology is primary and secondary. Secondary causes are secondary to other diseases. The primary etiology is of multiple origin. The most common one is the trigeminal nerve vascular compression theory, which is mainly caused by the vascular compression of the trigeminal nerve into the brainstem. There are also the trigeminal nerve demyelination theory and the central theory. Pain is the most prominent manifestation of the disease, and attacks are often without aura and are sudden and lightning-like in nature, such as cutting, burning, needling or electric shock. Between episodes there is no pain at all, as usual. Pain attacks can be accompanied by tearing, salivation, facial twitching and other symptoms, often pressing the palm of the hand against the face or rubbing hard, causing local facial skin roughness, thickening, and loss or sparse eyebrows in the long run. Each pain lasts 1-2 minutes and then stops suddenly, mostly during the day. More than half of the patients may have pain “trigger points” or “trigger points”, which are often located at the upper lip, nose, corner of the mouth, incisors, etc., and can be triggered by slight touching. In addition, talking, eating, washing face, brushing teeth, etc. can also cause attacks. For secondary trigeminal neuralgia, the primary disease should be treated actively. For primary trigeminal neuralgia, we can consider: i. Drug treatment The longest used is carbamazepine, 0.1g/time, 2 times/day. Surgery should be considered if drug treatment is ineffective. Second, surgical treatment Trigeminal nerve root microvascular decompression It is currently considered that this surgery can be the preferred surgical method for the treatment of primary trigeminal neuralgia. A bone window with a diameter of about 62.5 px is performed in the posterior mastoid area, and the surgical injury is small and the effect is very good.