Facial spasm, also known as hemifacial spasm, is typically characterized by involuntary twitching of the eyelid and facial muscles on one side. Current research suggests that the underlying cause of facial spasm is the compression of the facial nerve root by intracranial blood vessels, resulting in increased excitability of the facial nerve or facial nucleus, causing involuntary twitching of the muscles innervated by the facial nerve, which is commonly known as facial muscles. Facial muscle spasm can lead to changes in the patient’s face that affect communication with others and even form serious psychological disorders, endangering the patient’s physical and mental health. There are many treatments for facial muscle spasm, such as oral carbamazepine, acupuncture, Chinese herbal medicine, botulinum toxin injection, etc. However, the above methods can only achieve temporary results, and recurrence is inevitable. The only way to cure facial muscle spasm is through surgery, applying artificial pad cotton to pad the responsible blood vessels at the root of the facial nerve. The operation is minimally invasive, with a locked hole and a precise approach. The skin incision is only 6 cm and the hole in the skull is about 2 cm, and the whole operation is performed under a microscope and endoscope with electrophysiological monitoring. The electrophysiological monitoring is like a “precise guidance mode” for the surgery, which not only can accurately find the responsible blood vessel compressing the facial nerve and guide the operator to place the pad, but also can predict the postoperative efficacy under anesthesia, reducing the incidence of postoperative complications and improving the surgical efficacy, truly achieving the purpose of less trauma and higher cure rate.