Abstract Abstract Objective: Trigeminal neuralgia (TN) is a chronic facial pain syndrome. Although there exist several therapeutic methods, microvascular decompression (MVD) surgery is the most effective for pain relief. Most neurosurgeons preserve the superior petrosal venous complex to avoid possible complications. We claim that superior petrosal vein sacrification is not associated with debilitating complications. In this review, we report our own surgical outcomes in trigeminal neuralgia patients. Methods: Data from 63 patients, whose information was obtained from a group of 113 patients who underwent MVD surgery from 2008 to 2018, were reviewed retrospectively by the first author who was not part of the surgical team, and the pain conditions were evaluated objectively. We performed the MVD surgical technique in the park bench position with superior petrosal vein sacrification. Under these circumstances, patients have observed pain relief during the early postoperative period and during long-term follow-up. Results: Following surgery, pain relief occurred in 84% of patients during the early postoperative period and in 69.8% of patients during long-term follow-up. The major offending vessel was the superior cerebellar artery. Conclusion: MVD surgery, in particular for patients with typical pain, is one of the most effective treatment strategies for trigeminal neuralgia. Superior petrosal vein sacrification is a safe method that helps neurosurgeons to visualise the surgical area and perform a better work-up. Neurosurgeons should not be afraid to carry out superior petrosal vein sacrification. Keywords: Microvascular decompression; Surgery; Trigeminal neuralgia