Objective To study the contribution of enhanced 3D time-of-flight MRA in the diagnosis of neurovascular compression in the patients with trigeminal neuralgia.Methods Enhanced 3D time-of-flight MRA and MRI in 37 patients clinical suspected trigeminal neuralgia were analyzed retrospectively.Results We found 27 sides trigeminal nerve in 24 patients were compressed by vascular in the enhanced 3D time-of flight MRA.In 24 patients neurovascular compression was ipsilateral with trigeminal neuralgia,and the side without trigeminal neuralgia, vascular compression in 3 cases were found.There was statistics correlation between neurovascular compression and trigeminal neuralgia.The other 13 patients with trigeminal neuralgia were non-neurovascular compression.The trigeminal nerve was compressed by superior cerebellar artery in 14 patients,anterior inferior cerebellar artery in 5 patients,tortuous vertebral artery in 1 patient,malformation of vascular in 1 patient,other microvascular in 5 patients.Conclusion Enhanced 3D time-of-flight MRA,which is super than MRI,can clearly display trigeminal nerve and neighboring vascular.Int is the optimum technology of radiology to diagnose the neuroveascular trigeminal neuralgia and helpful for diagnosis and treatment.