The onset of facial muscle spasm is not an aura, and often occurs suddenly without notice. Many patients do not pay attention to facial myospasm, but the onset of the disease do not know that they are suffering from this disease, and naturally, they can not judge the condition according to the disease itself, and they do not know what items should be done and what tests should not be done when they go to the hospital. The diagnosis of facial muscle spasm depends mainly on the characteristic clinical manifestations. Typical facial muscle spasm means that the spastic symptoms start from the eyelids and gradually progress downward to involve the lower facial muscles such as the cheek expression muscles. In the resting state of the face, none of the muscles undergo involuntary jerking. In order to accurately distinguish facial myospasm from other muscle disorders, the physician needs to examine and compare the patient’s condition in detail with bilateral blepharospasm, Major’s syndrome, bite spasm, and posterior facial paralysis. The only way to cure patients with a confirmed diagnosis of facial spasm is to perform microvascular decompression. Microvascular decompression is currently the preferred treatment option for facial myasthenia, which is not only highly effective but also has fewer surgical risks. The vast majority of patients can retain normal facial appearance and function after surgery, but no procedure is absolutely safe and patients are evaluated with preoperative testing prior to surgery. Preoperative imaging is one of the most critical aspects of the assessment of facial spasticity. The MRI examination combined with electrophysiological assessment is performed to clarify the presence of anatomical contact vessels of the facial nerve and even to show the type and thickness of the vessels and the degree of compression of the facial nerve. Only when the above examinations are prepared, the prerequisites for the implementation of facial spasm surgery are available. Patients can then receive the safest surgical treatment for facial myasthenia with the lowest risk status.