Microvascular decompression for hemifacial spasm involving the vertebral artery (VA) can be technically challenging. Transposition of the VA using a bioglue-coated Teflon sling in these difficult situation is an effective surgical techniques. A figures of cover story, clockwise from top-left, shows intraoperative microscopic view. The loop of the VA and the posterior inferior cerebellar artery (PICA) are seen compressing the root exit zone (REZ) of the facial nerve. The VA was adequately lifted using the sling, which was fixed to the 5-0 black silk sutures on the petrosal dura. PICA was fully identified on the REZ only after transposition of the VA. An indentation was seen on the REZ after the decompression (arrowhead).