Percutaneous balloon compression is a simple and effective treatment for trigeminal neuralgia. It is especially useful in patients with first-division pain because it does not injure the myelinated fibers that mediate the blink reflex. It is most helpful in patients with pain that has spread across multiple divisions because it does not require multiple lesions. It is also helpful in patients with whom it would be difficult to communicate during selective thermal rhizotomy. It is a relatively easy to perform once you understand the principles of the technique.