This episode explores the historical development of microvascular decompression (MVD) surgery, tracing its evolution from Dr. Peter Jannetta's foundational work to contemporary techniques. Drawing from a narrative review published in Acta Neurochirurgica in 2026, we examine the anatomical and physiological principles that have guided MVD procedures for neurological conditions. The discussion highlights key milestones, challenges, and advancements in this critical surgical field, offering insights into its enduring impact on patient care. This content is for informational purposes and should not be considered medical advice. AI-generated content may contain errors.