Microvascular decompression (MVD) is currently recognized as the most effective treatment for hemifacial spasm. However, postoperative complications following MVD remain a significant clinical challenge, resulting in significant psychological stress and severely compromising patients‘ quality of life. This study reports a unique case of a hemifacial spasm patient with multiple post-MVD complications treated using the time-acupoints-space acupuncture meridional flux Nazi method (a traditional chronotherapy approach for time-specific acupoint selection). The intervention achieved significant therapeutic efficacy, underscoring the clinical value of integrating traditional Chinese medicine chronotherapy into postoperative rehabilitation. This case provides practical insights for optimizing multidisciplinary management of complex postoperative conditions and aims to share experiences with peers.