Background: Trigeminal neuralgia (TN) is a rare kind of face pain. It's characterised by a rapid onset of acute electric shock-like facial discomfort that's centred along the fifth cranial nerve's sensory distribution. Although many patients respond to medicinal treatment, when PTS symptoms become intractable and drugs are no longer effective, patients must seek surgical decompression. Our study aims to review about the correlation of vascular compression radiologically and during surgery and micro vascular decompression for trigeminal neuralgia and its outcome along with the review of literature. Methods: It's a retrospective study that looked at 40 people who were diagnosed with TN between July 2009 and July 2015. All of the patients have undergone MVD. We looked at demographic information, clinical presentation, surgical findings, complications, and long-term follow-up. Results: The median age of onset of TN is 50.4 years, with five age groups ranging from 24 to 89 years, with a 65.5 percent female preponderance over men. The ratio of right to left in the distribution of location was 1.5:1. The study found no evidence of mortality. Three patients in the study population experienced complications. Three patients exhibited facial hyposthesia, one had V3 paresis, and one had CSF otorrhoea, all of which were resolved with LP drainage. Except for one patient who had prolonged discomfort, all of the patients improved satisfactorily. Conclusions: To summarise, microvascular decompression (MVD) is the surgical method of choice for medically refractory TN patients who are surgically fit. MVD has the highest rate of long-term patient satisfaction and the lowest rate of pain recurrence of all the currently known surgical procedures.