There has been a quest for surgical treatments for movement disorders for over a century. At first the pyramidal system was interrupted to quiet involuntary motor behavior, but at the cost of paralysis. As knowledge of control of movement advanced during the first part of the last century, the extrapyramidal system became the target, with the goal of alleviating symptoms without weakness. When improved medical management for Parkinson's disease was introduced in the late 1960s, surgery for movement disorders became uncommon, but within the last decade it has rebounded significantly. It now appears that surgery will play an increas-ing role for treatment of motor disorders for the foreseeable future.