AIM: To compare the morphometric characteristics of the foramen ovale (FO) and foramen rotundum (FR), and their localization in the middle cranial fossa on the head and neck computed tomography images of patients with trigeminal neuralgia (TN) and asymptomatic individuals. MATERIAL and METHODS: The FO and FR length, width, and area parameters were examined in 158 asymptomatic individuals and 19 patients with TN. Their localization in the middle cranial fossa was determined according to the sagittal (y) axis passing through the middle of the dorsum sella and connecting the foremost point and the rearmost point of the skull and the transverse (x) axis passing through the middle of this axis. In the comparison with asymptomatic individuals, data on the painful side of patients with trigeminal neuralgia were used. RESULTS: The mean width of the FO and its distance from the transverse axis were determined to be 3.36 +/- 0.79 mm and 1.44 +/- 0.39 mm in asymptomatic individuals and 2.88 +/- 0.83 mm and 1.23 +/- 0.45 in TN patients, respectively. These FO parameters were statistically significantly smaller in patients with TN. In asymptomatic individuals, while the mean width of the FR was determined to be 2.05 +/- 0.48 mm, the mean length was 2.14 +/- 0.47 mm, and its distances to the transverse axis and sagittal axis were found to be 2.65 +/- 0.35 mm and 1.96 +/- 0.25 mm, respectively. In patients with TN, while the mean width of the FR was revealed to be 1.77 +/- 0.46 mm, the mean length was 1.78 +/- 0.42 mm, and its distances to the transverse axis and sagittal axis were found to be 2.33 +/- 0.40 mm and 1.87 +/- 0.16 mm, respectively. These FR parameters were statistically significantly smaller in patients with TN. CONCLUSION: Statistically significantly smaller dimensions of the FO and FR and their distances to the sagittal and transverse axes in patients with TN suggested that they might be among the causes of TN.