Long-term results of the medical treatment of Parkinson's disease are somewhat disappointing despite an increased longevity and a more prolonged functional ability. The appearance of iatrogenic side-effects lead some authors to withhold levodopa until severity of symptoms really warrants its use. In this context the place of neurosurgery is re-evaluated. With specific indications a correctly performed stereotactic operation is still the best therapy available capable of suppressing tremor, iatrogenic hyperkinesias and rigidity and must be considered when these symptoms incapacitate the functional and social life of the patient.