Facial spasm is a chronic functional disorder with long term recurrent attacks. It causes pain to patients and affects their life and work. With the development of medical technology, the use of minimally invasive surgery (microsurgery and endoscopic surgery) in neurosurgery can effectively and easily relieve patients’ pain. Facial muscle spasm, i.e. twitching of the facial muscles, is characterized by paroxysmal involuntary twitching of one side of the face, eyelid twitching, and tilting of the corners of the mouth, which can be aggravated continuously and even accompanied by tinnitus and hearing loss. The symptoms are more pronounced when nervousness is present, affecting the patient’s reading, vision and normal life and social activities, and even sleep. Facial muscle spasm needs to be differentiated from many related and similar diseases and treated differently. Therefore, patients should visit a regular hospital for diagnosis and treatment. Usually, after a clear diagnosis, the usual treatment is to choose conservative treatment such as medication first, and once the conservative treatment is ineffective or has high side effects, minimally invasive neurosurgical surgery can be chosen. Minimally invasive neurosurgery for facial muscle spasm, i.e. Mircovascular Decompression (MVD), is an internationally recognized treatment method with positive results. The procedure involves making a small incision in the occipital area behind the patient’s ear to open the skull, exposing the area where the nerve is compressed by the blood vessels, and using a small spacer (usually made of Teflon) to pad between the two to separate the nerve vessels and eliminate the cause of the disease. After the surgery, the patient’s symptoms may disappear immediately or gradually. This method is happily accepted by patients because of its advantages of being radical, not cutting the nerve and being less invasive. Recently, the use of neuroendoscopy in surgery has made the procedure more minimally invasive and further improved its efficacy. The advancement of minimally invasive surgical techniques has been a boon to patients.