Facial spasm (also known as hemifacial spasm) is a common functional neurosurgical disorder characterized by episodic hemifacial muscle twitching. The only recognized cure is microvascular decompression surgery (i.e., MVD surgery), in which a small bony window is made behind the affected ear and a posterior approach is made through the sigmoid sinus into the pontocerebellar horn region to explore the facial nerve roots and decompress the segment of the facial nerve. Adequate visualization and careful exploration are prerequisites for identifying the responsible vessels and performing adequate decompression. Due to the shortage of sophisticated medical equipment and instruments for neurosurgery and patient awareness of this disease, MVD surgery has not been promoted quickly. With the improvement of the national economic level and the people’s demand for better quality of life, more and more hospitals at the provincial and municipal levels have been carrying out such procedures in recent years. However, some problems are inevitable in the process of popularizing any new technology, and MVD surgery is no exception. MVD craniotomy requires to find another sign from one sign, each sign must be in place, and the lateral side of the bone window must reach the sigmoid sinus, otherwise, it is futile to have a large bone window, but increase the trauma, on the contrary, the pursuit of a small bone window will lead to inadequate exploration because of poor exposure, and the surgery will be ineffective because of missing the real responsible vessels; If the cranial opening is opened, the mastoid airspace should be found and closed with bone wax in time, otherwise the postoperative cerebrospinal fluid nasal leakage will easily lead to intracranial infection. Second, the arachnoid membrane is not sufficiently relaxed, the arachnoid membrane must be sufficiently sharply relaxed to reveal the entire intracranial segment of the facial nerve, and pulling the cerebellar villi in the premise of insufficient relaxation can easily cause postoperative hearing loss or loss, or even postoperative local bleeding causing serious problems; using ventriculoscopy to observe is not a substitute for adequate relaxation and exposure, because ventriculoscopy can only observe, not operate at the same time. Third, the pad cotton should not be placed properly After the responsible vessel is revealed, a suitable pivot point should be found to place the pad cotton to rearrange the position of the responsible vessel, and the location of the pivot point should be as far away from the compression point as possible, otherwise it is likely that the operation will be ineffective, which is very similar to the points given in our secondary school examination, and it is useless to answer more than the required knowledge points. Therefore, although the surgical technique for facial muscle spasm MVD is mature, it also needs to be standardized urgently. Standardized surgical treatment is the guarantee of efficacy and safety. The size of the open bone window is moderate and must go to the ethmoid sinus. The papillary air space is opened and closed in time to effectively prevent cerebrospinal fluid nasal leakage. Intraoperative slow release of cerebrospinal fluid and sharp release of the arachnoid create surgical space to reduce strains on cranial nerves and subcortical hematomas in the cerebellar hemispheres. Careful protection of the penetrating artery is required to reduce ischemic cranial nerve injury, and electrocoagulation and blunt dissection are used sparingly to reduce mechanical injury to the nerve, and the facial nerve is explored throughout the operation to avoid missing the responsible vessel. MVD surgery requires delicate operation and no room for error, as a predecessor said, a qualified neurosurgeon may not be a qualified MVD surgeon. It is because of its characteristics, so it needs to be practiced, experienced and summarized more in the clinical process and standardized as soon as possible. Minimally invasive surgery for facial muscle spasm has been carried out in the Department of Neurosurgery of Henan Provincial People’s Hospital since 2002, and in large numbers since 2009, with more than a thousand cases in 2015, with a surgical success rate of 93-95%, which is consistent with that reported in most of the literature published in English. Currently, more and more such surgeries are being performed (including MVD surgery for trigeminal neuralgia). In the course of surgical practice, we have summarized a set of standardized surgical procedures, covering the screening of surgical cases, preoperative examination, intraoperative operation points, postoperative observation and care, and postoperative follow-up. Not only fine results are required, but also fine procedures. At present, the minimally invasive surgical treatment of facial muscle spasm and trigeminal neuralgia in our neurosurgery department has formed a characteristic professional group, declared professional topics, published a series of articles, including international standard SCI articles and Chinese core journal articles, and the overall business level is leading in the province and well-known in the country, laying a foundation for the further development of our neurosurgery subspecialty. As the saying goes, the left eye jumps for money and the right eye jumps for disaster (superstition). A disease like facial muscle spasm, which used to be familiar and helpless to people, has been able to be treated safely and effectively with the development of neurosurgical subspecialty technology. May our lives get better and better!