Primary trigeminal neuralgia is divided into primary trigeminal neuralgia and secondary trigeminal neuralgia according to its etiology. Primary trigeminal neuralgia often presents as a lightning-like, knife-like severe pain in the trigeminal nerve distribution area of one side of the face, with paroxysmal recurrent episodes that last for several seconds or minutes, with intervals as normal. It is now widely believed that primary trigeminal neuralgia is caused by pulsatile vascular compression of the trigeminal sensory roots into the pontine brain (REZ), which is thought to be the intersection zone between the central and peripheral myelin sheaths, without Schwann’s cell encapsulation, and is particularly sensitive to pulsatile and transverse compressions that are prone to microvascular compression. Therapeutically, the pain can be relieved or even disappeared after surgery by removing the blood vessels compressing the nerve from the pontocerebral region using manifest microvascular decompression. Secondary trigeminal neuralgia, which usually occurs after some factors with clear pathological factors, causes trigeminal neuralgia. These pathological factors are various lesions near the trigeminal nerve root, which are described in detail below. 1, brain stem and intracranial tumors: pontocerebral rib tumor, brain stem tumor, meningioma, auditory neuroma, trigeminal neuroma, cholesteatoma, nasopharyngeal cannon, etc. 2, cerebrovascular lesions: cerebral bridge medullary ischemic lesions, medullary cavitation, basilar aneurysm, arteriovenous malformation, etc. may lead to secondary trigeminal neuralgia. 3, brainstem and intracranial inflammation: the causes of trigeminal neuralgia are also related to arachnoiditis and adhesions at the sensory roots of the trigeminal nerve in the brainstem, simple scar virus infection, typhoid fever, influenza, etc. 4, other causes: alcoholism, lead poisoning, other toxic diseases. Therefore, for the treatment of secondary trigeminal neuralgia, identification of the cause and active treatment can improve or cure the pain.