Trigeminal neuralgia (TN) is a severe, episodic facial pain disorder that significantly impairs the quality of life. While pharmacotherapy remains the initial approach, many patients develop refractory symptoms necessitating further interventions. Surgical options such as microvascular decompression (MVD) offer durable relief but are invasive and carry operative risks, particularly in elderly or comorbid populations. The effective and noninvasive alternative of stereotactic radiosurgery (SRS) is increasingly being used, especially for those with classical TN. SRS precisely targets the trigeminal nerve in the retrogasserian/cisternal segment using high-dose radiation (80–90 Gy), achieving sustained pain relief in 70–90% of patients. The precision of Gamma Knife and CyberKnife systems helps minimize complications such as facial numbness while targeting the nerve segment precisely. As imaging and delivery techniques evolve, the role of SRS is expanding in both primary and recurrent TN management, offering a safe, repeatable, and patient-friendly option.