Background Schwannomas are well capsulated, slowly growing benign tumors. These tumors arise from schwann cells that wrap the peripheral or cranial nerves; hence, these tumors are basically peripheral nerve sheath tumors. Aim of the Work to evaluate the result of different approaches for trigeminal schwannoma. Patients and Methods This retrospective study was conducted on 15 patients with trigeminal schwannoma who underwent different surgical modalities in the management at Ain Shams University Hospitals and Nasser Institute Hospital during the period from 2015 to 2019. Results Mean Preoperative GCS in this study was 15 preoperative, as GOS was 5 in 10 patients, 4 in 3 patients and 2 in 2 patients immediately postoperative while 3 months follow up shows that 14 patients GOS were 5 as one case was 1 (died). Headache was reported in 53.3% of our patients, SNHL and tinnitus were present in 80% of our patients, and facial pain and numbness were present in 33.3%, while vomiting & ocular movement were not presented among our patients. The tumor was right sided in 60% of our patients & the rest of patients 40% had left sided tumor. 26.7% of patients had tumor class A, 20% had tumor class B & 53.3% of them had class C tumor. Retrosigmoid approach was used in 6.7% of patients, Fronto-temporo-orbito-zygomatic (FTOZ) Dolanc approach was used in 26.7%, FTOZ approach was used in 6.7%, transzygomatic extradural subtemporal approach was used in 6.7%, Dolanc extradural subtemporal approach was used in 26.7%, extradural subtemporal approach was used in 6.7% & anterior petrosectomy (Kwase) approach was used in 20.0% of our study population. Partial resection was done for 26.7% of patients, Subtotal resection was done for 33.3% of patients, and complete resection was done for 40.0% of patients. Cavernous extension was present in 53.3% of our patients, Gamma Knife (GK) postoperative was needed in 53.3% of our patients & Pathology finding was Trigeminal Schwannoma (TS) in 100% of our patients. There was statistically significant difference between different approaches regarding Cavernous extension. As Cavernous extension was needed for all patients who underwent FTOZ Dolanc & Extradural subtemporal Dolanc only (p = 0.002). There was no statistically significant difference found between different approaches regarding the Extent of resection. Intra operative complications, Gk postoperative & pathology. Conclusion total removal via the proper approach can be the best treatment for trigeminal schwannoma with a low complication rate.