Background: We present preliminary results using Cyberknife radiosurgery as a noninvasive treatment for trigeminal neuralgia (TN). Methods: Ten patients with medically refractory TN who were deemed unsuitable for conventional surgery underwent Cyberknife radiosurgery using CT cisternography for localization. Results: Pain relief was achieved in 7 patients, in 5 of them within 24–72 h after irradiation. Conclusion: Cyberknife radiosurgery can achieve early-onset pain relief in a subset of TN patients. Improvements using this technique include the absence of a stereotactic ring, potentially improved targeting accuracy produced by CT cisternography and improved dose homogeneity.