〔Abstract〕 Objective To observe the curative effect of deep acupuncture at Xiaguan point with inclined angle and ordinary acupuncture at Xiaguan point in the treatment of trigeminal neuralgia. Methods Sixty-seven patients with primary trigeminal neuralgia admitted to Zhengzhou Hospital of Traditional Chinese Medicine from June 2019 to June 2021 were randomly divided into an observation group (34 cases) and a control group (33 cases). The observation group received inclined angle acupuncture at Xiaguan point, combined with local acupoint selection and hand-foot Yangming meridian acupoint. The control group received conventional acupuncture at Xiaguan point, and the other acupoints and acupuncture methods were the same as the observation group.The efficacy of the two groups after 3 courses of treatment was compared. Results The total effective rate of the observation group was higher than that of the control group, but the difference was not statistically significant (P > 0.05). The apparent rate in the observation group was higher than that in the control group, and the difference was statistically significant (P < 0.05). The frequency of pain attack in the groups after treatment were lower than those before treatment, and the frequency of pain attack in the observation group was lower than that of the control group, the difference was statistically significant (P < 0.05). Conclusion The slanting angle of deep acupuncture at Xiaguan point can significantly improve the clinical effect of trigeminal neuralgia compared with conventional acupuncture at Xiaguan point.