Report of a new technique for the treatment of major trigeminal neuralgia, consisting of exposure (with no opening) of the cavum Meckelli following an extradural approach. Four patients were operated on, with the same encouraging results obtained by others (Taarnhöj, Love, Norlen) employing different procedures. Although the author does not intend to give any explanation on pathogenesis of trigeminalgia he feels that the compression of the trigeminal roots inside the cavum Meckelli invoked by Taarnhõj as the mechanism of trigeminal neuralgia has lost its support.