Background <p>Trigeminal neuralgia is a debilitating condition that often requires surgical intervention. While microvascular decompression (MVD) is a standard surgical approach, we explored the efficacy of fibrin glue as an adjunctive technique in improving patient outcome.</p> Methods <p>Over a three-year period, 16 patients with trigeminal neuralgia underwent MVD with the application of fibrin glue at the conclusion of the procedure. The primary outcome was pain relief, assessed using the Barrow Neurological Institute (BNI) pain intensity scale, with a success defined as BNI Grade I (no pain, no medication required).</p> Results <p>All 16 patients (100%) experienced complete pain relief with no recurrence of symptoms over an average follow-up period of 5-yrs. Additionally, no significant adverse effects were observed related to the application of fibrin glue.</p> Conclusion <p>The adjunctive use of fibrin glue in MVD surgery for trigeminal neuralgia patients appears to enhance surgical outcomes, providing a 100% success rate in our cohort. This technique may offer a promising addition to the standard surgical approach, warranting further investigation through larger, randomized studies.</p>