【Abstract】 Objective To investigate the clinical effect and mechanism of acupoint catch embedding in the treatment of primary trigeminal neuralgia. Methods 60 patients with primary trigeminal neuralgia admitted to our hospital from July 2015 to March 2018 were included in this study. 30 patients set as the control group were treated with oral western medicine alone. 30 patients with acupoint catgut embedding therapy were set as acupoint catgut embedding group. Clinical efficacy, TCM symptom score, visual analogue scale (VAS), serum levels of IL-1β，IL-6, TNF-a, β-EP, VIP, 5-HT were compared between the two groups before and after treatment. Results After treatment, TCM symptom scores and VAS scores in acupoint catgut embedding group were significantly lower than those before and after treatment, and the differences before and after treatment were significantly higher than those in the control group (P<0. 01). After treatment, serum levels of IL-1β, IL-6, TNF-a and VIP in the acupoint embedding group were significantly lower than those in the control group and before treatment. The serum levels of β-EP and 5-HT were significantly higher than those in the control group, and the differences before and after treatment were significantly higher than those in the control group (P<0. 01). Conclusion Acupoint catgut implantation has a positive therapeutic effect on primary trigeminal neuralgia, and its overall clinical efficacy and analgesic effect are better than that of oral western medicine treatment. The mechanism may be related to the regulation of related inflammatory factors and neurotransmitters in primary trigeminal neuralgia.