【Abstract】Objective To explore the clinical diagnostic value of 3.0T magnetic resonance diffusion tensor imaging in trigeminal neuralgia hemifacial spasm. Methods From April 2016 to August 2018, 52 patients with trigeminal neuralgia and hemifacial spasm in our hospital were selected for analysis and set as the experimental group. 51 healthy persons admitted in the same period were selected as the control group. The clinical value of 30T MR diffusion tensor imaging (DTI) in the diagnosis of hemifacial spasm in trigeminal neuralgia by detecting the relationship between the facial nerve and peripheral vessels in the cerebellopontine angle (CAP) cistern with 3D TOF sequence and 3D CISS sequence were observed.Results There was significant difference in Hosoya score between the two groups (P＜005). There was no significant difference in bilateral Hosoya score between the two groups (P＞005). There was significant difference in Hosoya score between the experimental group and the control group (P＜005). Microvascular decompression (MVD) of facial nerve was performed in 32 patients with hemifacial spasm. The sensitivity, specificity, positive predictive value and negative predictive value of 3 0t MR diffusion tensor imaging for neurovascular compression were 941%, 867%, 889% and 929%, respectively.Conclusion The diagnosis and examination results of 30T magnetic resonance diffusion tensor imaging for patients with trigeminal neuralgia hemifacial spasm are satisfactory.