Abstract: Objective To analyze the influencing factors related to the postoperative recurrence of primary trigeminal neuralgia (PTN) treated with percutaneous balloon compression (PBC).Methods The clinical data of 108 PTN patients who initially received PBC in the Affiliated Hospital of Xuzhou Medical University from August 2020 to August 2022 were retrospectively analyzed. According to the follow-up, the patients were divided into two groups: a recurrence group and a non-recurrence group. Their preoperative, intraoperative and postoperative data were collected to analyze the influencing factors of pain recurrence.Results During the follow-up period of 12-36 months, 17 patients (15.74%) had recurrence of pain, and the time of recurrence ranged from 1 to 18 months after surgery. The results of univariate analysis showed that the differences between the two groups were statistically significant (P<0.05) for hypertension, compression time ≤2 min, and immediate postoperative facial numbness scores (Ⅰ+Ⅱ), while the differences in the other data were not statistically significant (P>0.05). The Cox regression model analysis using the statistically significant data in the univariate analysis showed that hypertension and the degree of facial numbness in the immediate postoperative period were risk factors for the recurrence of postoperative pain in PBC (P<0.05). The Kaplan-Meier method was used to analyze the survival of patients with and without hypertension and immediate postoperative facial numbness score, and the results showed that the probability of recurrence of PBC pain increased over time in patients with hypertension and less immediate postoperative facial numbness (P<0.05).Conclusions Hypertension and immediate postoperative facial numbness are risk factors for the recurrence of postoperative pain in PTN treated with PBC.