Introduction Trigeminal neuralgia is one of the most painful diseases known to man. Classical trigeminal neuralgia is characterized by stereotyped attacks of intense pain, of sharp or stabbing quality and can be provoked by trigger factors or trigger areas. It is widely accepted that a neurovascular contact in the cisternal segment of the trigeminal nerve is the primary cause of classical trigeminal neuralgia (Devor et al., 2002). Microvascular decompression (MVD) of the trigeminal nerve is a recognised treatment for trigeminal neuralgia, due to vascular compression. The neuroendoscope is not only a complementary tool but can totally replace operating microscope in microvascular decompression. Especially with the use of free hand technique, endoscopes can be taken in further to look behind the trigeminal nerve and also above and below. This amplifies the chance of identifying all the NVCs in a patient and hence reduces the recurrence rate. OBJECTIVES: To establish the usefulness of neuroendoscopes in CP angle surgery with special focus on microvascular decompression for trigeminal neuralgias using free hand technique. MATERIALS AND METHODS: This study deals with a purely endoscopic MVD of the trigeminal nerve using free hand technique through the retrosigmoid route in 50 patients who presented with trigeminal neuralgia from Jan 2015 to April 2019.RESULTS : Out of a total of 50 patients studied who underwent E–MVD , 48 had identifiable NVCs of which 3 had veins only ,2 had multiple arteries and veins and the rest had only arterial NVCs. Amongst the arterial alone group , 4 were due to AICA ,3 were due to AICA and branches of SCA, rest 36 were due to SCA or its branches.CONCLUSION: Use of neuroendoscopes allows one to identify all neurovascular conflicts effectively, even more so when one employs the free hand technique. Hence MVD can be accomplished in all the cases with less chance for recurrence , at the same time with very minimal morbidity and no mortalities