As with any surgical procedure, trigeminal neuralgia surgeries carry inherent risks. A comprehensive patient evaluation is essential for a successful surgical intervention. Co-existing health conditions such as hypertension, diabetes, or chronic lung diseases can increase the risk of post-operative complications; therefore, effective management or treatment of these conditions prior to surgery is crucial. In addition to anesthesia-related and general systemic risks, each surgical procedure also has its specific risks. All these risks can be significantly reduced through the surgeon's experience, meticulousness, and advanced surgical techniques.

Specific risks that may be encountered in microvascular decompression (MVD) surgeries include:
* Wound complications (infection, healing problems)
* Cerebrospinal fluid (CSF) leakage
* Temporary facial paralysis or weakness
While most of these risks can be prevented with careful and diligent work by the surgeon, they can never be entirely eliminated.

In percutaneous ablation treatments applied via the foramen ovale, the following risks may be observed:
* Persistence of pain (ineffectiveness of treatment)
* Permanent facial numbness
* Dry eye
* In very rare cases, the development of permanent facial pain
When balloon compression is chosen as the ablation method, the probability of developing permanent facial pain is considerably low. However, this risk can be higher with radiofrequency and alcohol applications.