Can migraines be treated surgically? Many people may have such a question. A relative of mine was also surprised when she came to see me and Director Zhao and suggested surgery, saying that after seeing many hospitals, she had never heard of surgical treatment at all. Let’s explore about this issue. At present, the causes of migraine, like most diseases, are not clearly understood. There are various theories, among which the vascular-neural compression theory has been promoted, and its explanation is the same as the cause of trigeminal neuralgia, that is, the tortuous compression of blood vessels and irritation of nerves. For this reason, the microvascular decompression that we are going to talk about today was created. Here is an intraoperative picture of a recent surgery. It is often said that migraine patients do not need surgery and that medication is sufficient to relieve the pain. This minimally invasive approach can be used for those patients who are ineffective with multiple medications or who cannot tolerate the side effects of medications. The procedure is more effective when the pain is relieved by pressing on the anterior superficial temporal artery in front of the ear. The procedure can be completed with local anesthesia and can be completed in half an hour. A small incision is made in the scalp in front of the ear, and the responsible tortuous vessels are found enough to be cut during the operation. The overall efficiency of this surgery is nearly 90 percent. The main reason for not reaching 100% is the complex etiology mentioned earlier, and the theory of vascular nerve compression can only explain most cases. It is important to be psychologically prepared before this surgery.