Trigeminal neuralgia is a common clinical disease, mostly seen in middle-aged and elderly people, once the disease is diagnosed, it is difficult to cure and the pain is severe and seriously affects daily life. Due to the lack of sufficient medical knowledge and medical information, most patients often seek medical treatment blindly, which makes it difficult to get timely and correct treatment, which not only delays the disease, but also leads to loss of confidence in the treatment of the disease due to repeated ineffective treatment. There are many ways to treat trigeminal neuralgia, such as oral carbamazepine, acupuncture, massage, radiofrequency, surgery and other methods, so what exactly is trigeminal neuralgia and does it need to be operated. Trigeminal neuralgia is divided into two major categories, primary and secondary. First of all, “secondary trigeminal neuralgia”, as the name suggests, occurs after certain factors, that is to say, there are clear pathological factors that cause trigeminal neuralgia. These pathological factors include various lesions near the trigeminal nerve root, such as tumors (common ones are cholesteatoma, auditory neuroma, meningioma and other tumors located near the pontocerebellar angle), inflammation and its post-inflammatory local adhesions, vascular malformation, hemangioma and so on. For these trigeminal neuralgia with a clear lesion as the cause, the treatment plan is to eliminate the lesion in order to eradicate trigeminal neuralgia. The means to eliminate the lesions is surgery, as the saying goes, “If the broom doesn’t work, the dust won’t run away by itself.” The same applies to the so-called “primary trigeminal neuralgia”, the cause of which is now known, that is, the root of the trigeminal nerve emanating from the cerebral bridge is stimulated by the local pressure of small blood vessels, causing abnormal excitation of the trigeminal nerve, and once this nerve is excited, it sends out pain signals to report to the patient’s brain “There is pain here” – the patient then feels as if his face is cut and burned, even though there is nothing on the patient’s face at the time. Therefore, to treat primary trigeminal neuralgia fundamentally lies in removing these blood vessels compressing the nerve and inserting medical spacers (TEFLON) between the blood vessels and the nerve, so that the trigeminal nerve is completely free from the compression of the blood vessels. This treatment is called microvascular decompression. Although many patients are desperate for a cure because of severe pain, they are always worried and afraid at the mention of surgery, always thinking that surgery will require opening the skull and “making an incision inside the brain”, and often end up not daring to undergo surgical treatment, especially for patients with relatively mild symptoms. In fact, microvascular decompression surgery for trigeminal neuralgia is a very mature surgical technique that has been in clinical use for more than 60 years, and the surgery is not performed inside the brain, but in the subarachnoid space between the brain tissue and the skull, so the risk of surgery is quite low. Especially in recent years, the application of minimally invasive surgical techniques has not only significantly improved the surgical efficacy, but also greatly reduced the risk of surgery. Microvascular decompression surgery is currently the preferred option for the international radical treatment of trigeminal neuralgia.