INTRODUCTION: Trigeminal neuralgia (TN) develops as a result of the trigger of one or more branches of the trigeminal nerve by stimuli. Most cases of TN are usually caused by compression of the trigeminal nerve root, within a few millimeters from its exit from the pons. In this study, we aimed to present our experience regarding the microvascular decompression surgical approach and itsresults in the treatment of patients who applied to the clinic with a diagnosis of TN and who did not respond to any of the treatments. METHODS: Microvascular decompression (MVD)surgery was performed on a total of 7 patients with TN who applied to the clinic between 2020 and 2021, and the information of the patients was retrospectively evaluated using surgery reports, epicrisis, and magnetic resonance images (MRI). RESULTS: It was observed that all 7 patients with TN were initially administrated carbamazepine and/or oxcarbazepine, implemented radiofrequency thermocoagulation treatment and gamma knife radiosurgery. Subsequently, all the patients underwent MVD surgery. No complications developed in the postoperative period and complaints of TN in all patients completely resolved in the early period. DISCUSSION AND CONCLUSION: In patients who are unresponsive to treatments, thin-section ‘constructive interference of steady state (CISS)’ sequence cranial MRI are useful to detect trigeminal nerve compression caused by intracranial pathologies, and MVD surgery is important in the treatment.