The purpose of this study was to evaluate the efficacy of radiofrequency trigeminal rhizotomy in treating 135 patients harboring trigeminal neuralgia, and to introduce a technical modification to guide the puncture of the foramen ovale. A hundred and one (74.8%) patients were treated with a single surgical procedure whereas the 34 (25.2%) remaining patients required two procedures. Follow-up ranges from 6 months to 15 years. Pain relief in the immediate postoperative was achieved in 131 (97.0%) patients. After the initial procedure, recurrence happened in 33 (24.5%) patients. The complications included decrease corneal reflex (4.4%), masseter paresis (2.2%), painful dysesthesia (1.5%) and anesthesia dolorosa (0.7%). The radiofrequency trigeminal rizhotomy is a low risk, highly effective and minimally invasive procedure. The use of the computerized tomography guided fluoroscopy turns foramen ovale's puncture easier, fast and precise.