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Although earlier studies showed higher values of wall shear stress in neurovascular conflict, hemodynamic patterns in the blood vessel after microvascular decompression are unknown. This study aimed to analyze the hemodynamic features of the offending artery preoperatively and postoperatively using computational fluid dynamics. We retrospectively analyzed 11 patients with trigeminal neuralgia who were surgically treated in our department during 2022. All patients underwent pre- and postoperative computed tomography angiography. Hemoscope software was used for computational fluid dynamics analysis. This analysis included 11 patients, median age 71 years (54.5% of female patients). Superior cerebellar artery was the most common offending vessel. In all 11 patients, elevated values of wall shear stress were found in the area of neurovascular contact. Postoperatively, with improvement of the patient clinical status, there was also a decrease in wall shear stress. Computational fluid dynamics analysis of offending vessels in trigeminal neuralgia can be a useful tool in preoperative planning and in assessing treatment outcomes and prognosis.