The aim of the case report is to investigate the pathogenesis relationship between atlantoaxial rotary subluxation and trigeminal neuralgia.Methods：Four cases，having trigeminal neuralgia(TN) who were at same time suffering from atlantoaxial rotary subluxation，were treated by Chinese manipulations(a little like chiropractic) which is unique to TCM and observe the efficacy for trigeminal neuralgia.Related literatures have been reviewed to explain the clinical effectiveness.Results：The symptoms of TN in 4 patients disappeared within a week after receiving only Chinese manipulations.The average follow-up period is 0.5 years，the longest reaches one decade and one year.3 of the patients do not have the symptoms of PTN any more，1 case relapsed two times in 11 years，the mean interval is 5 years，however，the symptoms also vanished after receiving the same Chinese manipulations.Conclusion：We consider that the two diseases probably have some relations in pathogenesis.We need observe more cases to further the research.