Most facial spasms are paroxysmal involuntary twitches of the hemifacial muscles, usually limited to one side of the face, hence the name hemifacial spasm, occasionally seen in both. It starts from the orbicularis oculi muscle and gradually develops to the cheeks and even the whole half of the face, and the reverse development is less common. It can be aggravated by fatigue and tension, especially when speaking and smiling, and in severe cases it can be spastic. The diagnosis of facial myospasm relies on the physician seeing the characteristic clinical manifestations. 94% of facial myospasm starts with eyelid fluttering, but the patient still needs a head MRI. The common cause of facial myospasm is due to neurovascular riding across, so simple medication is not curable, early patients can still be effectively controlled by drugs, long-term use is very little effect, if long-term failure to cure may cause facial nerve damage, most cases, especially patients with the disease within 8 years, through the treatment of apparent microvascular decompression, are able to restore the normal function of the facial nerve. In recent years, with the clarification of the etiology, microvascular decompression of the facial nerve has become the first choice for the treatment of primary facial spasm, and microvascular decompression is used to treat the etiology and achieve a curative effect. The procedure is performed by microscopically pushing away the blood vessels located at the root of the nerve with abnormal alignment and causing compression to the nerve, and fixing them with Teflon cotton pads so that the blood vessels do not touch the nerve, thus releasing the compression of the blood vessels to the nerve root and restoring the normal function of the nerve to achieve the purpose of curing the disease. Microvascular decompression has now become a common method of neurosurgery internationally for the radical treatment of facial muscle spasm. Its advantage is that it can preserve the facial nerve while relieving local vascular compression, and rare complications include hearing impairment, facial palsy, and tinnitus. Advanced surgical and monitoring equipment can effectively reduce the occurrence of complications and guarantee the safety of surgery.