&NA;Trigeminal neuralgia in its classic form is usually an isolated disease that occurs in sporadic fashion without epidemio‐logical or genetic significance. This paper discusses a family with three nontwin sisters, all of whom have classic trigeminal neuralgia occurring in early middle age with symptoms severe enough to require medical and surgical treatment. These three sisters also have one aunt with a history of severe facial pain, although this has not been medically documented. Clustering of such cases in a given family has been reported before, but is rare. The pathophysiological implications of this genetic clustering are discussed. (Neurosurgery24:758‐761, 1989)