Objective To preliminarily investigate the clinical significance of digital subtraction angiography （DSA）-assisted three-dimensional reconstruction technique in minimally invasive percutaneous balloon compression of the trigeminal nerve in hybrid operating room.Methods The clinical data of 15 patients with trigeminal neuralgia who were treated by percutaneous balloon compression with DSA-assisted three-dimensional reconstruction technique from January 2019 to January 2021 were retrospectively analyzed. The number of punctures， intraoperative balloon shape， postoperative clinical response rate， and incidence of complications were evaluated.Results Fourteen patients were punctured successfully for the first time， and 1 patient was punctured twice， with the first success rate of puncture of 93.3%. During the operation， 13 patients had pear-shaped balloons， and 2 patients had approximately pear-shaped balloons. Thirteen patients had completely disappeared symptoms after the operation， and 2 patients had significant relief. No complications of other cranial nerve injuries， intracranial hemorrhage， and intracranial infection occurred.Conclusions DSA-assisted three-dimensional reconstruction technique can effectively assist precise puncture to improve the success rate of surgery， and has important clinical significance. ［Journal of International Neurology and Neurosurgery, 2022, 49(6): 46-49］