Abstract: Objective To verify the effectiveness and safety of MR-guided focused ultrasound(MRgFUS) in treatment of refractory essential tremor. Methods According to the ET002 J clinical trial protocol, subjects were recruited from the first medical center of Chinese PLA General Hospital in January 2019. The symptoms of tremor were evaluated using CRST scale. All patients underwent left ventral medial nucleus ablation by MRgFUS. Results Totally 3 subjects were recruited in our study, including an 66 year-old male, a 76 year-old male and a 66 year-old female. The duration of symptom in the three patients was over 10 years, and they all had a family history. All of them could be identified as refractory essential tremor. At baseline vs after treatment, the resting, postural and action tremor score of CRST scale was 20 vs 11 in subject 429301, 16 vs 6 in subject 429302, and 16 vs 7 in subject 429303, with an average improvement over 50%. Their handwritings were also significantly improved. One subject experienced transient balance disorder, while no adverse reaction was observed in other two subjects. Conclusion We preliminarily proved MRgFUS favorable efficacy and safety in treatment of refractory essential tremor, which indicating a promising practice applicability and providing evidences for further application in other major central nervous system diseases.