Trigeminal neuralgia is called the “world’s first pain”, and its recurrent attacks are the main reason why it is difficult to cure trigeminal neuralgia, and also an important manifestation of the deterioration of trigeminal neuralgia. Due to the pain of trigeminal neuralgia, it brings a great impact on the life of patients. How to cure trigeminal neuralgia has become a growing concern. Zeng began to have left-sided facial pain 10 years ago. The pain area was mainly located in the inner canthus, with paroxysmal pins-and-needles pain, accompanied by frontal cramps and facial swelling, and the pain could be aggravated by eating. He was diagnosed as “trigeminal neuralgia” in the local hospital and took oral carbamazepine, which reduced the symptoms. Since then, the frequency of pain attacks gradually increased and the effect of oral carbamazepine diminished. The effect of oral carbamazepine was diminishing. It seriously affected his daily life. In order to seek further surgical treatment, he came to the neurosurgery department of the hospital and was admitted to the hospital with “left trigeminal neuralgia”. After completing the relevant tests, he underwent microvascular decompression of the left trigeminal nerve under general anesthesia. Postoperative treatment was given to prevent infection, stop bleeding, nerve nutrition and fluid replacement. After the operation, Zeng’s left facial pain symptoms basically disappeared, and the pathological reflexes were not elicited. The wound had all been removed and Professor Wang instructed after examination that the patient’s condition was stable and could be discharged. Zeng’s daily life was seriously affected by trigeminal neuralgia, he felt uncomfortable every day, did not want to move and had no spirit. Later, after the hospital’s neurosurgery department did the apparent microvascular decompression for him, the pain was improved and the person was psychiatric. Trigeminal neuralgia is a common disease among middle-aged and elderly people, with short attack time but severe pain, which is often unbearable for patients. Washing face, eating, brushing teeth, and breeze may trigger the pain. Therefore, to get rid of the pain, early treatment is needed. Carbamazepine and oxcarbazepine are commonly used drugs, and surgery can be considered for severe cases. The general indications for microvascular decompression for the treatment of trigeminal neuralgia include: 1. Those who meet the typical clinical manifestations of primary trigeminal neuralgia, and CTA and MRA examination are clearly vascular compression. 2. Those who have been diagnosed with vascular compression and have poor or ineffective drug treatment and side effects. 3.Patients who have been diagnosed with vascular compression and have poor effect or recurrence of treatment with radiofrequency and nerve block. 4. Those who have no important organ disease and can tolerate surgery. Those who are generally under 80 years of age. 5.Patients who understand the procedure and have a request for surgery.