There are two types of eyelid fluttering: physiological and pathological. In physiological eyelid fluttering, the episodes are short and the fluttering is not serious. Most of them are caused by insufficient rest, eye fatigue or eating irritating foods and drugs. This kind of eyelid jumping does not affect health and has nothing to do with luck or misfortune. Generally, no special treatment is needed. When the throbbing is more frequent, it can be relieved by sufficient rest, local massage or hot compress, etc. and will subside automatically. If the intermittent throbbing for 3-6 months is not obvious, the possibility of self-remission is very small, considered pathological. Pathological eyelid fluttering is the early manifestation of facial muscle spasm, mostly starting from the lower eyelid, involuntary fluttering, the condition is progressive development, episodes gradually frequent, the duration of each fluttering gradually prolonged, the fluttering amplitude gradually increased, can affect the corners of the mouth, cheeks, and even half of the face. More serious facial muscle spasm can make half of the face in a state of continuous spasm, mouth and eyes distorted, and over time will also cause facial muscle atrophy, affecting the patient’s appearance, bringing great inconvenience to daily life and work. The annual incidence of this disease is 11/1 million. The usual conservative treatment methods such as oral medication, acupuncture, nerve closure and nerve destruction are ineffective or relapse soon. The root of the facial nerve is compressed by blood vessels and the lesion is the root cause of the majority of facial muscle spasms. Very few of them are secondary to intracranial tumors, aneurysms, arteriovenous malformations, sarcoidosis, cysts, and other lesions. Neurosurgical microvascular decompression for this cause has been practiced and improved over the years and has become the treatment of choice for facial myasthenia. The procedure is performed under general anesthesia, and the surgical incision is located in the hairline behind the ear, about 3-4 cm long, with a skull window after cutting the skin, about 1.5×2 cm in diameter. Teflon cotton is placed between the blood vessel and the nerve to keep it away from the facial nerve and to relieve the compression to achieve the treatment purpose. After the operation, the patient has to stay in bed for 3 days and can be discharged after the incision is removed in 7 days. The Department of Functional Neurosurgery of Xuanwu Hospital performs microvascular decompression of the facial nerve root under electrophysiological monitoring to treat facial muscle spasm, with an overall efficiency of about 95%. Patients may have transient headache, dizziness, nausea, vomiting and other reactions after the operation, and most of them can disappear within 3-5 days. There is a possibility of facial paralysis and hearing loss after surgery, generally less than 2%, and most of them can gradually recover within 3 months to 6 months once they occur. The incidence of other complications such as intracranial hematoma, cerebellar injury, infection, and cerebrospinal fluid leakage are extremely low. In conclusion, facial nerve root microvascular decompression for facial spasm is an effective and safe procedure, and has become the preferred method of treatment at present.