Clinical presentation: Patients present with brief episodes of severe pain (often described as stabbing or electric shock-like) confined to the innervated area of the trigeminal nerve, with some patients having painful trigger points, also mostly in this area. The second and third branches of the trigeminal nerve are the most common, and therefore, many patients present with perioral pain. Diagnosis: It mainly relies on clinical manifestations and affective examinations are mainly used for etiological examination. Aetiology: trigeminal neuralgia can be divided into primary and secondary. The latter refers to those with a clear etiology, such as localized tumors, etc. Primary refers to those without a clear cause (this statement should be abolished, with the development of imaging, 85% of patients with primary trigeminal neuralgia have vascular compression of the trigeminal nerve, while vascular compression exists in more than 95% of patients in surgery). Treatment: Once trigeminal neuralgia is diagnosed, treatment with carbamazepine can be given, starting at a dose of 100 mg twice a day and increasing by 50 to 100 mg every two days if the pain is not controlled, until the pain is controlled or drug complications occur, with meals. If the drug is not tolerated, baclofen is available, which is slightly less effective. Surgery is recommended for those not controlled by medication (most patients eventually require surgery). Surgical indications: Patients with a diagnosis of trigeminal neuralgia that is not controlled by medication require further treatment and may be considered for surgical treatment, which includes microvascular decompression (MVD) and percutaneous neurodesis. Each has advantages and disadvantages. The former requires general anesthesia, craniotomy, etc., and is suitable for patients with relatively young age and good physical health, and this treatment does not damage the nerves and can be cured; the latter surgery is less invasive, but permanently damages the nerves and is not cause-specific and prone to recurrence. Pre-operative evaluation: MRtA shows the trigeminal nerve and its surrounding vessels, and determining whether it is compressed by these vessels is an important factor in deciding whether to treat it surgically. Surgical results: more than 95% of patients were found to have intraoperative vascular compression of the trigeminal nerve, of which, about 80% were arterial compression, and among the arteries, 80% were from the superior cerebellar artery. More than 80% of patients had pain for hours immediately after surgery, and another 5% to 10% of patients had pain that disappeared after several weeks. 90% of patients were cured in the long term, 5% of patients needed to continue medication, and 5% of patients needed to do neurodesis. Complications: cerebral infarction for 1-2%, hemorrhagic cerebellar infarction in 0.5-1% of patients, half of which are fatal and are the main cause of death from this procedure. The incidence of cranial nerve fatigue is high in the fourth, sixth, seventh and eighth, with 1-3% in the fourth, 05% in the sixth, 2-5% in the seventh and 1-4% in the eighth. Most of the nerve damage can be recovered, except for hearing damage which is not easily recovered.