Trigeminal neuralgia, also known as painful convulsions, is a transient episode of sharp tearing-like severe pain in the facial distribution of one or more branches of the trigeminal nerve, with a specific facial expression during painful episodes, remission periods as normal, often with trigger points, and a generally long duration of illness without positive neurological signs. Research over the last 20 years has shown that trigeminal neuralgia is caused by compression of the trigeminal nerve at the exit of the pontine brain by abnormal blood vessels. The purpose of microvascular decompression is to relieve the compression of the trigeminal nerve by the abnormal blood vessels to eliminate the facial pain. Microvascular decompression is a minimally invasive locked-hole surgery with a small incision in the hairline, which is less invasive, safe and efficient, and is currently the best choice for the radical treatment of primary trigeminal neuralgia.