The Trigeminal Neuralgie (TN) is he most common cause of facial pain with an incidence of 27 per 100'000 patients per year. The symptoms are paroxysmal stabbing, tearing, and burning pain usually in the area of the second and third trigeminal nerve, that can be provoked by drinking, shaving, chewing or talking. If the classical drug therapy with anticonvulsants is not sufficient or must be discontinued due to side effects, then the retrosigmoidal craniotomy and micro-vascular decompression in vascular-nerve-contact ot partial rhizotomy are good pain-free procedures. Such operations are of low risk in the hands of experienced neurosurgeons and possible to be carried out even in elderly patients. A high percentage of free of complaints postoperative and low recurrence rate legitimate this method.