Abstract ObjectiveTo investigate the clinical effect of retrosigmoid approach for the treatment of primary trigeminal neuralgia.Methods84 patients with primary trigeminal neuralgia in our hospital from December 2014 to December 2016 were randomly divided into the observation group(n=42)and the control group(n=42),the observation group was treated with posterior decompression via retrosigmoid approach,the control group was treated with percutaneous semilunar ganglion radiofrequency thermocoagulation,the therapeutic effect,postoperative complications and recurrence were compared between the two groups.ResultsThe total effective rate of the observation group was 88.09%,which was higher than that of the control group(66.67%),the incidence of postoperative complications(23.80%)was less than that of the control group (47.61%),the cure rate and recurrence after operation were significantly better than those of the control group,and the differences were statistically significant(P<0.05).ConclusionThe treatment of primary trigeminal neuralgia by retrosigmoid approach has significant curative effect.It has high cure rate,less recurrence and less postoperative complications.It is worthy of clinical promotion and application.