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Objective To evaluate effectiveness and complication in microvascular decompression (MVD) treating idiopathic trigeminal neuralgia (ITN).Methods Data from.78 tfigeminal neuralgia cases dealt with microvascular decompression were retrospectively and systematically analyzed.Results Immediate complete relief were found in 67 cases (85.9%),partial relief in 7 cases (8.9%) and failure in 3 (3.8%).After a follow-up for 3-37 months in 71 cases,recurrence were found in 5 cases (7.5%).Non-completed peripheral facial paralysis in 7 cases(8.9%)、prosopo-numbness in 5 cases (6.4%)、acoustic sensibility degression、ambiopia and bourdounement in each 4 cases (5.1%),coordination dyskinesia in 3 cases (3.8%) and intracranial infeion、epilepsy in each 2 cases (2.6%) were found after operation,but no death was found.Conclusion Microvascular decompression is a safe and efficient way in treating idiopathic trigeminal neuralgia and pay great attention in the entire decompression procedure is the key point to elevate therapeutic efficacy.