Objective To investigate the effect of stellate ganglion block （SGB） on cognitive function， nerve microcirculation， and P2X2/3 receptor expression in rats with trigeminal neuralgia. Methods A total of 45 rats were divided into normal group， model group， and SGB group using a random number table， with 15 rats in each group. All rats except those in the normal group were used to establish an animal model of trigeminal neuralgia， and 2 rats in the model group and 1 in the SGB group died during modeling. After modeling， the rats in the SGB group received SGB with 5 mg of 0.5% ropivacaine injected between the C6 and C7 transverse processes， while those in the other two groups were injected with an equal volume of normal saline. Von Frey filaments were used to measure pain thresholds for each group； the water maze test was used to assess cognitive function； gelatin-ink perfusion and transparent specimen preparation were used for focus stacking of infraorbital nerve tissue； HE staining was used to observe nerve pathomorphology； Western blotting and qRT-PCR were used to measure the expression levels of P2X2 and P2X3. Results Compared with the normal group， both the model group and the SGB group had a significant reduction in pain threshold （P0.05）； compared with the normal group on days 1， 3， and 7 after injection， the model group had a significant reduction in pain threshold （P0.05）； compared with the model group， the SGB group had a significant increase in pain threshold （P0.05）. Compared with the normal group， the model group had a significant increase in escape latency and a significant reduction in the number of platform crossings on days 1，2，3，4， 5， 6， and 7 after intervention （P0.05）， and compared with the model group， the SGB group had a significant reduction in escape latency and a significant increase in the number of platform crossings on days 1， 2， 3， 4， 5， 6， and 7 after intervention （P0.05）； infraorbital nerve tissue was collected after gelatin-ink perfusion， and a microscope was used to take photos continuously under 12-fold magnification； focus stacking with Zerene Stacke showed that in the normal group， infraorbital nerves and vessels grew along the nerve axis with the presence of larger capillaries， and branches penetrated into the nerve tracts and formed a capillary network； the model group had no large vessels and showed reductions in the number and density of horizontal vessel branches while the SGB group showed certain improvements. HE staining showed that the normal group had regular morphology of ganglion cells without disruption， intact cell membrane， and clear cell nucleoli， and the model group had irregular morphology and rupture of ganglion cells， while the SGB group had clearer nucleoli and an increase in microvascular density. Compared with the normal group， the model group had significant increases in the expression levels of P2X2 and P2X3 （P0.05）， while compared with the model group， the SGB group had significant reductions in the expression levels of P2X2 and P2X3 （P0.05）. Conclusion SGB can increase pain thresholds， improve cognitive function， and enhance nerve microcirculation in rats with trigeminal neuralgia， possibly by inhibiting the expression of P2X2/3 receptors.