Since the first introduction of the trigeminocardiac reflex (TCR) in 1999, substantial new knowledge about this brainstem reflex has been created. First, by different clinical case reports and case studies, and second, from basic research that gives inputs from bench to bedside. In the present work, the authors therefore introduce the molecular/anatomical knowledge of the TCR and show its different connections to clinical aspects. Special reference is given to prevention and treatment of the TCR; but always with a link to knowledge of the basis sciences. In such a context different topics of future interest are introduced.