Neurosurgery at the Barrow Neurological Institute exists within the unique context of this nonuniversity-based center. The institute, a relative newcomer to academic medicine, opened in Phoenix in 1961 under the leadership of John Raymond Green, M.D., who remained its medical director until his retirement at the end of 1985. Since then, the institute has experienced a dynamic growth phase in its clinical and academic arenas. This article describes how the development of the institute has shaped the program in neurosurgery and vice versa.