For many patients with trigeminal neuralgia, oral administration of carbamazepine is highly effective. Micro decompression surgery (Jannetta's operation) is also considered a fundamental treatment. However, there are patients who do not respond to carbamazepine and who hesitate to have surgery. Here, we report 14 cases whose pain was relieved solely by Kampo (7 cases) or by a combination of Kampo and carbamazepine (7 cases). The Kampo formulations used were Goshuyu-to (2 cases), Gorei-san (9 cases), Saiko-keishi-to (1 case), Toki-shigyaku-ka-goshuyu-shokyo-to (1 case) or Mao-bushi-saishin-to (1 case), depending on the “Zheng” of each patient. In trigeminal neuralgia, the nerve root is compressed or adhered to surrounding vessels, such as the superior cerebellar artery. It is highly possible that localized edema at the point of compression is responsible for the pain. The diuretic action of the Kampo may diminish the localized edema around the trigeminal nerve root.