This investigation evaluates the results of percutaneous trigeminal ganglion compression (PTGC) and compares them those for microvascular decompression (MVD) in treating trigeminal neuralgia. The authors report 127 cases of trigeminal neuralgia treated by PTGC and comparing the results with those of 114 patients whom underwent MVD from 1985 to 2000. The following parameters were compared: technical success, pain relief and recurrence, complications, perioperative morbidity, and perioperative mortality. PTGC and MVD initially had similar initial success rates. However, MVD had a higher rate of pain recurrence at the first 2 years follow-up, as well as higher rates of major complications and perioperative morbidity. Meanwhile, PTGC had higher rates of facial numbness, dysesthesia and minor complications.