Diagnostic capabilities of MRI for recognition of neurovascular conflict in patients with classical trigeminal neuralgia (CTN) are still discussed. Analyzing the anatomical relationships of trigeminal nerve root (TNR) with superior cerebellar artery (SCA) on 100 facial specimens of persons without CTN, the authors describe various neurovascular contacts. Some ones can transform into neurovascular conflict as damping properties of arterial wall are lost in accordance with hydrodynamic laws. The authors described 2 variants of neurovascular conflict between TNR and SCA after microvascular decompression in 100 patients. Both variants were diagnosed after CT angiography. The first type is observed only in patients with CTN (65% of cases). The second type is observed in 35% of patients with CTN, but it also occurs on the intact side and in people without CTN. FIESTA imaging does not provide adequate data on neurovascular conflict. The authors believe that MRI programs providing quantitative characterization of TNR demyelination at the site of neurovascular conflict will be valuable to differentiate neurovascular contact from neurovascular conflict.