Facial spasm is an episodic, recurrent, involuntary twitching of the facial muscles innervated by the facial nerve. The incidence ratio is about 1:3 with trigeminal neuralgia. Involuntary facial twitching causes interpersonal and social interaction disorders, resulting in great psychological stress and burden. Etiology: primary and secondary. Primary: The facial nerve is compressed by abnormal blood vessels in the bridge section of the brain, resulting in a “short circuit”. Secondary: Most of the facial nerve is injured for various reasons until the recovery period and intracranial occupancy of the pontocerebellar angle. Examination: Electromyography of the facial nerve suggests high-frequency rhythmical discharges. MRI of the pontocerebellar horn region shows vascular and cerebral nerve riding across. Treatment: Due to the poor effect of medication, other treatments such as closure tend to bring the risk of facial palsy. Facial nerve root microvascular decompression has been used as the treatment of choice, and 95% of patients stop twitching immediately after surgery.