Many patients are in severe pain because of trigeminal neuralgia, glossopharyngeal neuralgia, or because facial spasm seriously affects their daily work and life, and they are eager to cure the disease, but when it comes to surgery, they are always worried and afraid, and they always think that surgery will open up the skull and “open up the brain”. This is especially true for patients with relatively mild symptoms. In fact, this is a misconception, microvascular decompression surgery is a very mature surgical technique for the treatment of trigeminal neuralgia, glossopharyngeal neuralgia, facial muscle spasm and other cranial nerve diseases, and has been used in clinical application for nearly 60 years. Microvascular decompression is a method of treatment that separates the blood vessel (cause) that is compressing the nerve root from the nerve root and then relocates and fixes it at a site away from the nerve root to achieve complete decompression of the nerve root. The surgery involves cutting a 5-6 cm scalp behind the ear, biting off a hole about the size of a dollar coin, operating intracranially through a microscope, and using surgical instruments to separate the blood vessels compressing the trigeminal, glossopharyngeal, and facial nerve roots so that the vessels no longer compress the nerve roots. In this way, trigeminal neuralgia, glossopharyngeal neuralgia and facial spasm are fundamentally solved, and the results are immediate. Microvascular decompression surgery is currently the preferred international solution for the radical treatment of trigeminal neuralgia and facial spasm. Its greatest advantages are the treatment for the cause, high rate of complete cure and efficiency of pain, low recurrence rate, few complications, and preservation of the normal function of the nerve after surgery. Of course, microvascular decompression is not without any risk. The magnitude of the risk depends on whether there are abnormalities in the development of the local anatomy, the number and thickness of the compressed vessels, and the relationship between the vessels and the nerve roots. Therefore, the higher the number of compressed vessels, the thicker the vessels, and the heavier the adhesions between the vessels and the nerve roots, especially in a few patients with anatomical variations, are the main factors that increase the risk of surgery. Therefore, detailed pre-numerical evaluation and skillful surgical technique are the keys to improve the surgical efficacy and reduce the surgical risk. In general, this surgery is quite safe, but after all, it is an operation on the head, and the common risks of surgery are as follows: 1. Facial numbness: This surgery rarely results in facial numbness after surgery, and even if it does, it is temporary and will gradually recover after surgery. If the nerve is partially cut, there is definitely numbness after surgery, but this is a different kind of surgery. 2. Tinnitus and hearing loss: Because the auditory nerve and trigeminal nerve are close to each other, the microvessels on the auditory nerve may be stretched during surgery, and sometimes this strain may lead to hearing loss and tinnitus. More than 90% of this tinnitus and hearing loss can be recovered after surgery. Only very few have long-term complications. 3. Wound and intracranial infection: the incidence is low. 4.Intracranial hemorrhage: rare, including intracerebral hematoma and subdural hematoma. The former has many causes, while the latter may be related to the collapse of intracranial brain tissue causing avulsion of small veins. 5.Subcutaneous effusion: mostly caused by poorly closed dural suture, which is generally not very relevant. 6.Life-threatening: mainly because the patient originally had heart disease or cerebral vascular sclerosis, or intracranial and large artery aneurysms, as well as the original patient has potentially more serious diseases, etc., caused by the surgery itself is extremely rare. In conclusion, microvascular decompression surgery for trigeminal neuralgia, glossopharyngeal neuralgia and facial spasm has high cure rate and efficiency, low recurrence rate, few complications and is quite safe.