History in neurosurgery is as essential as the scalpel or the anaesthetic. Every decision in the operating room is shaped by what came before—published outcomes, the wisdom of past mentors and the lessons of history. This book delves into the origins of British and Irish neurosurgery, marking one hundred years since the founding of the Society of British Neurological Surgeons. Drawing on newly uncovered, unpublished primary sources—many generously shared by neurosurgical families—this work offers a fresh perspective on the formative years of the specialty. It explores the early challenges faced by the pioneers, from the limitations of medical science to the professional resistance they encountered. The narrative also highlights the profound impact of international collaboration and the transformative influence of two world wars, particularly the global conflict of 1939–1945, which demanded courage, innovation and resilience. From the creation of a unique network of surgical units to groundbreaking scientific advancements, this book celebrates the remarkable achievements of the field’s forebears. It is a tribute to their originality, dedication to patient care and relentless pursuit of progress. Written to inspire young surgeons and captivate any reader with an interest in the history of medicine, this book is a call to carry forward the same spirit of innovation and excellence that has defined neurosurgery for more than a century.