Microvascular decompression (MVD) surgery for trigeminal neuralgia (Jannetta operation) is common in our institution, and postoperative complications are uncommon. However, a 46 year-old obese female who underwent MVD surgery for right trigeminal neuralgia suffered from postoperative neurologic deficits consisting of left facial palsy, left total deafness, weakness and numbness of the left arm, and unsteady gait. Here, we bring forth the patient's postoperative events, such as delayed emergence, postoperative convulsions, pneumocephalus, and probable causes of the neurologic deficits for discussion.