Background: Radiosurgery is one of the neurosurgical alternatives for ă intractable trigeminal neuralgia (TN). Objective: Although acceptable ă short-/mid-term outcomes have been reported, long-term results have not ă been well documented. Methods: We report the long-term results in 130 ă patients who underwent radiosurgery for classical TN and were ă subsequently monitored through at least 7 years (median = 9.9, range = ă 7-14.5) of follow-up. Results: The median age was 66.5 years. A total of ă 122 patients (93.8%) became pain free (median delay = 15 days) after ă the radiosurgery procedure (Barrow Neurological Institute, BNI class I ă IIIa). The probability of remaining pain free without medication at 3, ă 5, 7 and 10 years was 77.9, 73.8, 68 and 51.5%, respectively. Fifty-six ă patients (45.9%) who were initially pain free experienced recurrent ă pain (median delay = 73.1 months). However, at 10 years, of the initial ă 130 patients, 67.7% were free of any recurrence requiring new surgery ă (BNI class I IIIa). The new hypesthesia rate was 20.8% (median delay of ă onset = 12 months), and only 1 patient (0.8%) reported very bothersome ă hypesthesia. Conclusions: The long-term results were comparable to those ă from our general series (recently published), and the high probability ă of long-lasting pain relief and rarity of consequential complications of ă radiosurgery may suggest it as a first and/or second-line treatment for ă classical, drug-resistant TN. (C) 2016 S. Karger AG, Basel