NEUROSURGERY STARTED IN Oxford in 1938. In this article, we commence the story of Oxford neurosurgery with Thomas Willis and trace the historical thread through William Osler, Charles Sherrington, John Fulton, and Harvey Cushing to Hugh Cairns. The department in Oxford is renowned for the training of neurosurgeons. The initial stimulus for this was the abundance of neurosurgical and neurological expertise in Oxford during World War II with Cairns, and this tradition continued with Joe Pennybacker and his successors. The large and ever increasing work load ensures trainees a wide exposure to challenging neurosurgical problems. An increasing emphasis placed on research has resulted in the creation of two posts; each consists of half-time clinical neurosurgery and half-time research. Hugh Cairns organized the department along “Cushing lines.” This organization still exists, allowing us to treat a large number of patients with relatively few beds and an average length of patient stay less than 6 days. We look to the future with confidence.