THE PRACTICE OF neurological surgery at the University of Wisconsin has evolved and expanded greatly over the past nearly 70 years. From its beginnings as a 1-man division of general surgery, the Department of Neurosurgery has grown to the current department consisting of 14 neurosurgeons and 12 full-time researchers, along with fellows, residents, nurse practitioners, laboratory personnel, and support staff. The department is able to take advantage of the unique opportunities provided by this large research institution to foster close collaborations between surgeons and researchers, both within and outside of the department. This article chronicles the development of the Department of Neurological Surgery at the University of Wisconsin, directed by its 3 chairmen, in the context of the University, the state of Wisconsin, and the Midwestern United States. Copyright © 2010 by the Congress of Neurological Surgeons.