To analyze the clinical features, treatment, and prognosis of patients with herpes virus infection after microvascular decompression. Methods：We reported the clinical data of 2 patients with herpes virus infection after microvascular decompression and retrospectively analyzed the relevant literature. Results： A literature search revealed 7 previous cases fulfilling the criteria of this study. We combined these 7 cases with our 2 and analyzed a total of 9 cases. Among them, 5 were infected by the varicella-zoster virus, 3 by the herpes simplex virus, and 1 by an unidentified virus; 6 cases had primary trigeminal neuralgia, and 3 had hemifacial spasm. The most common symptom was facial herpes (5 cases). Some patients developed atypical symptoms such as fever and headache (4 cases), ocular conjunctivitis (1 case), facial paralysis (1 case), and facial muscle spasm (1 case). All the patients were given acyclovir for antiviral treatment; clinical symptoms were subsequently improved, and prognosis was good. Conclusion：The clinical features of fever, facial pain, facial muscle spasm, facial paralysis, and ocular symptoms after microvascular decompression may indicate herpes virus infection. Physicians should closely monitor the patients’skin for the presence of herpes, perform serological or cerebrospinal fluid virus testing when necessary, and administer antiviral treatment in a timely manner.