Objective To investigate the influencing factors for the clinical effect of microvascular decompression （MVD） in the treatment of primary trigeminal neuralgia.Methods Related clinical data were collected from 64 patients with primary trigeminal neuralgia who underwent MVD in Xinyu People’s Hospital to analyze the possible influencing factors for postoperative treatment outcome.Results All 64 patients had typical primary trigeminal neuralgia and were treated with MVD. After surgery， 48 patients （75.0%） were cured， 12 （18.8%） achieved remission， and 4 （6.2%） had no response. There were 2 patients with tinnitus， 1 with facial paralysis， 2 with subcutaneous hydrops， 1 with intracranial infection， and 6 with high fever. No serious complications such as cerebral hemorrhage and cerebral infarction， as well as death， were observed. The multivariate analysis showed that course of disease， degree of compression， and degree of surgical decompression were influencing factors for prognosis （P <0.05）.Conclusions Course of disease， degree of trigeminal nerve compression， and adequacy of surgical decompression are the main influencing factors for the surgical outcome of trigeminal neuralgia. ［Journal of International Neurology and Neurosurgery, 2021, 48(1): 17-20］