Trigeminal neuralgia is a painful condition that occurs in one side of the head, face, jaw, and around the dental cavity in the area innervated by the trigeminal nerve. Typical trigeminal neuralgia is characterized by paroxysmal, brief pain episodes, each lasting from a few seconds to a few minutes, intense and unbearable pain, pain in the form of electric burns, pins and needles, knife-cutting, tearing, etc. The episodes may be accompanied by facial muscle convulsions, with the corners of the mouth drawn to one side; the pain mostly occurs unilaterally and never spreads to the midline, with trigger points (trigger points) along the distribution area of the trigeminal nerve, such as the upper and lower lips, corners of the mouth, teeth, tongue, and cheeks. teeth, tongue, and cheek, which can be triggered when washing, brushing, drinking, talking, or shaving, seriously affecting the patient’s daily life. To choose the treatment method, we need to understand the pathogenesis of trigeminal neuralgia first. The trigeminal nerve originates from the midbrain and pontine brain of the human brainstem. The trigeminal nerve is divided into 2 parts, and most of its functions are responsible for the sensation of the face and head, including pain sensation, touch sensation, facial proprioception (i.e., feeling that the face is one’s own), and the sensation of the front two-thirds of the tongue. As age increases, the blood vessels in the brain become tortuous and displaced, and thicker vessels such as the superior cerebellar artery and the anterior inferior cerebellar artery close to the trigeminal nerve and compress the trigeminal nerve. The fluctuations of the arteries impact the trigeminal nerve for a long time, resulting in demyelination of the trigeminal nerve (breakage of the skin on the outside of the nerve), causing disorders in the nerve conduction inside the trigeminal nerve, which in turn leads to trigeminal neuralgia. Therefore, the fundamental treatment for trigeminal neuralgia is to remove the blood vessels that are compressing the nerve and insert a medical spacer (TEFLON) between the blood vessels and the nerve, so that the trigeminal nerve is completely free from the compression of the blood vessels. This treatment is called microvascular decompression and is a cure. Trigeminal nerve microvascular decompression is a minimally invasive procedure that differs from conventional open surgery in that the minimally invasive operation reduces or even avoids complications for the patient. The responsible blood vessel compressing the nerve is removed under a high-definition microscope during the surgery, and then the damaged nerve is wrapped, isolating the nerve from the blood vessel, and the patient’s painful symptoms disappear immediately after the surgery. The operation time is shorter, almost no damage to the patient’s nerves and blood vessels, and there are fewer post-operative complications. Equipped with international first-class equipment such as high-definition microscope, 16-channel electrophysiological monitor, nerve navigation, power system, microscopic instruments, etc., we have carried out more than 2000 cases of trigeminal nerve microvascular decompression with an efficiency of 98%.