Trigeminal neuralgia is a painful condition of the face characterized by paroxysmal lancinating, shock-like pain confined to the somatosensory distribution of the trigeminal nerve. The etiology of most cases of tigeminal neuralgia has been suggested to be vascular compression of the central axons of the trigeminal nevre at the level of pontocerebellar region, so called hyperactive disfunctional syndrome. Trigeminal neuralgia is the one of the most known pain syndromes. Several neurosurgical procedures have been developed for the treatment of idiopathic trigeminal neuralgia and in this review, idiopathic trigeminal neuralgia was discussed in aspect of different surgical modalities.