The neurological institute of New York was founded in 1909 as the first hospital in North America devoted exclusively to the care of patients afflicted with neurological diseases. The Institute amalgamated with Columbia University's College of Physicians and Surgeons and The Presbyterian Hospital in New York City in 1928. The Department of Neurological Surgery developed under the successive leadership of Charles Elsberg, Byron Stookey, J. Lawrence Pool, Lester Mount, Edward Schlesinger, and Bennett Stein, each of whom brought unique qualities to the role of Department Chairman. This article traces the history of the Institute and its affiliates, present activities, and future plans.