author： Chen Guoqiang， Email： guoqchen@mail.tsinghua.edu.cn 【Abstract】 Objective To investigate the effect of microvascular decompression（ MVD） on the treatment of hemifacial spasm（ HFS） associated with the vertebral artery complex. Methods We retrospectively analyzed the data of 1 033 patients with HFS admitted to the General Aviation Hospital from May 2014 to August 2016. According to the responsibility vascular， the patients were divided into vertebral artery complex group （208 cases） and non-vertebral artery complex group（ 825 cases）. Patients were followed up for 12 to 28 months. The effect of MVD was compared between the two groups. Results The difference in age between the two groups was not statistically significant， but the proportion of males in the vertebral artery complex group was higher（ 54.3% vs 20.5%） and more frequent on the left side（ 81.7% vs 51.0%）. The difference was statistically significant（ P＜0.01）. The satisfaction rate of MVD in vertebral artery complex group was 95.1%（ 198/208）， and the failure rate was 1.9%（ 4/208）. There was no significant difference between the vertebral artery complex group and non-vertebral artery complex group（ 94.9%， 1.2%）. There was no significant difference in short-term and long-term complications between the two groups（ P＞ 0.05）. Conclusions In terms of surgical cure rate and complications， the MVD results are similar between the vertebral artery complex group and the non-vertebral artery complex group. The MVD can be used as one safe and effective method for treating compression type of vertebral artery complex HFS.