Aim: This study aimed to review our experience with patients who suffered from recurrent trigeminal neuralgia (TN) and underwent repeat microvascular decompression surgery (rMVD). Material and Methods: This observational study is based on retrospective analysis and was conducted at the Department of Neurosurgery in a university hospital. It included patients who initially experienced complete pain relief after the first MVD but later had a recurrence of TN symptoms and subsequently underwent rMVD. Pain control outcomes were evaluated based on the Barrow Neurological Institute (BNI) scale score. Results: Out of a total of 375 patients who underwent MVD for TN over a 20-year period, 19 patients (6 females, 13 males) with a mean age of 57.68 ± 9.78 years suffered from recurrent symptoms necessitating rMVD (%5.06). The average duration of symptoms before rMVD was 16.1 ± 19.36 months. The mean BNI score of the patients before rMVD was 4.5 ± 0.5. recurrence was primarily attributed to compression by a new offending vessel (n=9, 47.4%) and Teflon granuloma formation (n=8, 42.1%). Two patients (10.5%) showed no compression. During a follow-up period of 106.3 ± 58.3 months, excellent pain relief (BNI-I) was achieved in 10 patients (52.6%). Eight patients (42.1%) experienced a good outcome (BNI-III), while one patient (5.3%) had a poor outcome (BNI-IV). Conclusions: Recurrence of TN symptoms can occur even after initially successful MVD procedures. Repeat MVD should be considered as the primary treatment option in recurrent cases, as it can lead to significant pain control with low morbidity. Keywords: Microvascular decompression, outcome, partial sensory rhizotomy, recurrence, trigeminal neuralgia