Trigeminal neuralgia is a recurrent, intermittent, severe pain in the distribution of the trigeminal nerve in the face. Most patients have a clear “trigger point”, and the clinical symptoms are distinctive, making the diagnosis relatively easy to confirm. Because the symptoms are clear and are mostly due to vascular compression of the nerve, MRI and CT examinations in the past have often failed to yield positive results. In addition, most treatment plans for trigeminal neuralgia do not require imaging guidance, and because of various factors such as economics, both physicians and patients tend to overlook imaging for trigeminal neuralgia. Our team has recently found several cases of patients with trigeminal neuralgia caused by tumors that have not been clearly diagnosed for a long time each year, suffering from pain for nothing and missing the best time for treatment. Given that most of the tumors in this region are benign, the safety and total resection rate of surgery are significantly higher when performed at an early stage when the tumor is small than at a later stage, we strongly recommend that all patients with trigeminal neuralgia should undergo early cranial MRI to rule out the possibility of intracranial tumors.