For the study of cause and treatment of recurrent trigeminal neuralgia, repeat operations were performed in 12 patients with recurrent trigeminal neuralgia after microvascular decompression. Among repeat operations, there was vascular loop recompression at trigeminal root in 10 patients, negative exploration in 2 patients. The pain relief was achieved after neurovascular redecompression or neurolysis in all patients. The patients had no recurrent pain during a follow-up from 6 months to 4 years. The causes of recurrent trigeminal neuralgia after microvascular decompression and the questions related to repeat operations were discussed.