For primary trigeminal neuralgia, the dominant surgical treatment method is surgery, which is often referred to as microvascular decompression. Trigeminal neurological microvascular decompression is a treatment for the cause of the disease, with an efficiency of more than 90% and a low recurrence rate, and can preserve the normal function of the trigeminal nerve. Patients with primary trigeminal neuralgia are very painful and have painful attacks. Many patients say that the pain is unbearable and seriously affects their life and work, so they are very willing to be treated. However, there are certain risks associated with microvascular decompression, so strict indications and contraindications are needed. Contraindications to primary trigeminal neuralgia surgery are: 1. Patients with facial pain that has not been excluded from secondary trigeminal neuralgia. 2. Patients with severe systemic diseases such as severe hypertension, heart disease, or important organ damage. 3.Patients with coagulation disorders and bleeding tendency. 4.Patients who have been clearly diagnosed with multiple sclerosis. 5.Patients who are too old and physically weak. The common comorbidities of microvascular decompression for trigeminal neuralgia are: cerebrospinal fluid leakage, aseptic meningitis and hemorrhagic infarction. Of these, hemorrhagic infarction can be a fatal comorbidity. Also, additional damage to the adjacent nerves may occur, and complications such as hearing loss and temporary facial nerve palsy may occur. Although the incidence of these comorbidities is not high, they are still there after all, and can be very problematic once they fall on a particular patient. If a patient with trigeminal neuralgia is within the contraindications for microvascular decompression surgery, it is time to consider other treatment options. Gamma knife treatment is currently a better method, which is less risky and safer compared to surgery. In recent years, with the development of gamma knife technology, the efficiency of the treatment of trigeminal neuralgia also reached 90%. In addition, the cost of Gamma Knife is also lower compared to surgery, and patients who are afraid of microvascular decompression are recommended to choose Gamma Knife.