Trigeminal neuralgia is a recurrent paroxysmal severe pain in the trigeminal nerve distribution area, i.e., the face, and is the most common of the neuropathic pain disorders. The prevalence rate is 182 per 100,000 people in China. The clinical manifestations are: facial pain is paroxysmal, brief and intense, with each attack lasting from a few seconds to a few minutes. The pain is electric, knife-like, and tear-like. The pain intervals are as normal. There are often trigger points in the trigeminal nerve distribution area on the diseased side, such as upper and lower lips, nose, roots of teeth, tongue, etc. Patients often have pain attacks triggered by washing, brushing, shaving, eating, and opening the mouth for speech. Therefore, it is easy to be misdiagnosed as dental disease in clinical practice. Before treating trigeminal neuralgia, we should first determine whether it is primary or secondary. If secondary trigeminal neuralgia is caused by tumor, surgery should be performed to remove the cause of tumor, and if it is primary trigeminal neuralgia, it can be treated by medication or surgery. In recent years, a large number of clinical studies and surgeries have confirmed that a considerable part of the etiology is caused by microvascular compression of the trigeminal nerve root. Also MRI angiography can detect such microvascular compression of the trigeminal nerve root. The treatment of trigeminal neuralgia by microvascular decompression has an efficiency of over 90%. Indications for microvascular decompression surgery for trigeminal neuralgia: 1. typical TN manifestation, “trigger point” exists; 2. exclude multiple sclerosis and CPA tumor; 3. drug tolerance, toxic side effects, poor efficacy; 4. <80 years old, no serious organic disease, can tolerate surgery; 5. cannot accept other treatments after facial numbness; 6. Preoperative cranial MR (3D-SPGR) examination suggests close relationship between trigeminal nerve roots and neighboring vessels; 7. Patient's choice of surgical intention. Comparison of radiofrequency treatment and microvascular decompression for trigeminal neuralgia: 1. Radiofrequency treatment Advantages: safe, wide age and tolerance requirements; short hospital stay; easy to repeat treatment. Disadvantages: symptomatic non-allopathic treatment; destructive; alteration of facial sensation; risk of corneal sensory loss; severe sensory abnormalities; prone to recurrence. 2, microvascular decompression treatment Advantages: nerve preservation, non-destructive; no numbness and sensory abnormalities; no corneal sensory loss; 3, etiology-specific, potentially curative Disadvantages: general anesthesia required; craniotomy; surgical complications. 4, pathological basis of surgical efficacy The effect of vascular compression on the nerve root is a progressive and proportional process. The degree of trigeminal nerve root compression (simple contact, adhesion, axial displacement, atrophy) determines the extent of pain, whether the symptoms are typical and the efficacy of MVD surgery.