Facial muscle spasm, also known as facial muscle twitch, is a paroxysmal, rhythmic, spastic or tonic seizure of one side of the facial muscles, starting from the orbicularis oculi and gradually expanding downward to the orbicularis oris and facial expression muscles, which can cause facial pain and facial paralysis in severe cases, affecting vision, speech and sleep. The cause of facial muscle spasm is not fully understood, but microvascular compression of the facial nerve root is the main cause of facial muscle spasm. If the microvessels are distracted, the facial muscle spasm can be relieved. Medication: Carbamazepine, phenytoin sodium, baclofen and other drugs can be tried, but they are not effective. Acupuncture or physiotherapy can reduce the symptoms, but cannot cure it. Surgical treatment is suitable for patients for whom medication and physical therapy are ineffective. Surgical methods include: botulinum toxin injection, ethanol injection, cervical mammary foramen thermocoagulation, facial nerve dissection, and microvascular decompression. Currently, Botox injection and microvascular decompression of the facial nerve are the most commonly used methods. Microvascular decompression is the only treatment that is specific to the cause of the disease and has a definite and long-lasting effect. The purpose of microvascular decompression of the facial nerve is to relieve the compression of the facial nerve by the microvasculature and the arachnoid membrane. The surgical efficiency is 87%-94%, and the recurrence rate is 6%-13%. The procedure is performed by a posterior approach to the inferior occipital sigmoid sinus with a 3-4 cm diameter bone window, cutting the arachnoid membrane along the nerve root and its compressed vessels, and placing Teflon cotton between the nerve root and the responsible vessels. Intraoperatively, the facial muscle spasm can disappear. Facial nerve microvascular decompression, with simple surgery, real efficacy, no damage to facial nerve function and few complications, is currently the best method for treating facial muscle spasm.