Objective To explore the status quo of social alienation in patients with primary trigeminal neuralgia and analyze its influencing factors. Methods This study was a cross-sectional study. From January 2022 to May 2023， convenience sampling was used to select primary trigeminal neuralgia patients who visited the Department of Pain in Xuanwu Hospital， Capital Medical University as participants. A survey was conducted using the General Information Questionnaire， General Alienation Scale （GAS）， and Stigma Scale for Chronic Illness （SSCI） to analyze the social alienation and stigma scores of patients with primary trigeminal neuralgia. Pearson correlation was used to analyze the correlation between social alienation and stigma， and multiple linear regression was used to analyze the influencing factors of social alienation. A total of 256 questionnaires were distributed， with 248 valid questionnaires and an effective response rate of 96.88%. Results Among 248 patients， the total scores of GAS and SSCI were （29.69±4.74） and （59.60±15.84）， respectively. There were statistically significant differences in the total GAS score among patients of different genders， primary caregivers， course of disease， and degree of pain （all P ＜ 0.05）. The total score of GAS in patients was positively correlated with the total score of SSCI， and the difference was statistically significant （r=0.372， P＜ 0.001）. Multiple linear regression analysis showed that the primary caregiver （spouse：β=-1.425， P=0.011； children： β=-1.384，P=0.026）， course of disease （β=2.363， P＜ 0.001）， degree of pain （β=2.437， P＜ 0.001）， and the total scores of SSCI （β=0.075， P ＜ 0.001） were the influencing factors of social alienation in patients with primary trigeminal neuralgia， with statistically significant differences， explaining 45.7% of the total variation. Conclusions Patients with primary trigeminal neuralgia experience social alienation， which is influenced by their primary caregiver （parents）， course of disease， degree of pain and stigma.