Microvascular decompression is currently the treatment of choice for facial muscle spasm and the only treatment that can cure it radically, so choosing microvascular decompression surgery is the best way for all patients to achieve their dream of a cure. Microvascular decompression is a minimally invasive surgical technique, which is the process of separating, displacing and properly fixing all the blood vessels that are compressing, adhering and touching the facial nerve. Generally speaking, the relationship between blood vessels and facial nerve can be divided into four types: simple contact, adhesion, compression and displacement, and entanglement, among which simple contact is the simplest, with short operation time and minimal operation risk, while entanglement is much more difficult, with significantly longer operation time and increased operation risk. The degree of compression of the facial nerve by blood vessels will gradually increase as the disease progresses, making the surgery more difficult, so early surgery may reduce the surgical risk and improve the surgical efficacy. The facial nerve and the auditory nerve are companions in the cranium, so the vessels compressing the facial nerve may also compress the auditory nerve and cause tinnitus or even hearing loss. The main risk of microvascular decompression is the stripping and pulling of the facial and auditory nerves during the separation process leading to transient facial palsy or hearing loss, but most of these symptoms can be recovered without too much worry, and postoperative medication and care according to the doctor’s recommendations will be sufficient.