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Objective: Trigeminal neuralgia occurs in 1-7% patients with multiple sclerosis (MS). We assessed the efficacy of microvascular decompression of the trigeminal nerve in MS patients., Material and Methods: We studied MS patients with trigeminal neuralgia who underwent microvascular decompression of the trigeminal nerve. Results and сonclusion. The superior cerebellar artery was compressed in 5 patients, the vein in 1. At the follow up of 3-5 years, no relapses of trigeminal pain syndrome were observed after the successful surgery. There were no complications of surgical treatment. Indications to this treatment should be made on the basis of MRI.