Trigeminal neuralgia (TN) is a severe form of recurring paroxysmal pain resembling an electric shock or a knife cut that affects one or more sensory distribution areas of the trigeminal nerve on one face side. This condition is also known as "the first pain in the world," and it is referred to as "the most severe pain ever experienced by a human." The majority of patients experience unilateral onset and the attack may have a "trigger point" and end abruptly. On the affected side, there may be simultaneous tearing and salivation. Carbamazepine has a powerful analgesic effect. TN is currently caused by a variety of factors, including: vascular compression, nerve compression, facilitation caused by changes in central plasticity, myelin degeneration, viral infection, and other space-occupying lesions like arteriovenous malformation, aneurysm, vestibular schwannoma, meningioma, and other types of cysts and tumors. The majority of researchers currently accept the theory that neurovascular compression is the primary cause of TN. Vascular compression around the intracranial segment of the trigeminal nerve is thought to play a significant role in the pathogenesis of TN, according to this theory. A few studies have found no obvious arterial compression on magnetic resonance imaging (MRI), indicating that the majority of the responsible blood vessels are arteries. This study evaluated the surgical strategies, curative effects, and postoperative complications of 35 patients with TN whose clinical MRI data did not show any obvious arterial compression.