Objective: To explore the value of microvascular decompression in the treatment of trigeminal neuralgia. Methods: The clinical data of 80 patients with trigeminal neuralgia who admitted to our hospital from February 2015 to February 2019 were retrospectively analyzed. The patients were randomly divided into two groups. The control group received routine treatment, and the observation group underwent microvascular decompression. Results: The total effective rate of the observation group was higher than that of the control group, P < 0.05. The recurrence rate of the observation group was lower than that of the control group, P < 0.05. Conclusion: Microvascular decompression for the treatment of trigeminal neuralgia can significantly improve the efficacy and reduce the recurrence.