Till not so long ago the very thought of having brain surgery would send shivers down the spine of the patient – and not without reason. Advances in diagnostics - the CT, MRI and PET scans, advances in anesthesia and ICU care, and advances in surgical techniques especially the use of microscope during surgery have all contributed to making brain surgery safe and uncomplicated for the last 20 to 30 years. There is further refinement in the last couple of decades to increase precision and improve outcomes, and to breach new frontiers. The trend has been towards minimally invasive neurosurgery and surgery for functional disorders. These newer techniques include surgery for intractable epilepsy, surgery for movement disorders, neuro-endoscopy, interventional neuroradiology, spinal instrumentation and fixation, computer assisted and stereotactic neurosurgery, and radiosurgery. Aiding all these efforts is increasing sophistication in the operating theatre – the use of high quality operating microscopes, intra-operative ultrasound, high speed drills, ultrasonic aspirator, intra-operative EEG monitoring, intra-operative evoked potentials, awake craniotomy and image guidance.