ANTON VON EISELSBERG was the first to resect a cerebral tumor at the First Surgical Clinic at the General Hospital in Vienna in 1904. He successfully removed a cerebral glioma, the first of no fewer than 15,000 tumors operated on at that hospital to date. von Eiselsberg and his successors, Egon Ranzi and Leopold Schönbauer, as heads of the First Surgical Clinic, devoted themselves intensively to brain surgery, and neurosurgery developed to be an integral part of Viennese surgery. During the first decades, a prominent neurologist, Otto Marburg, and a world-famous anatomist, Julius Tandler, were members of the neurosurgical operating team. This approach changed in the 1950s, when the brain surgeons aimed at becoming independent of the basic sciences. The founding of an independent neurosurgical department at the University of Vienna in 1964 under Herbert Kraus also marked the beginning of the formation of specialized sections for pediatric and stereotactic neurosurgery. After 1968, the operating microscope was greatly emphasized. As of 1970, cerebral tumors and cerebrovascular lesions were treated microneurosurgically. Many operations were performed by surgeons who were experienced in neurosurgery. This again changed in 1978 under the new head of the department, Wolfgang Koos, who regarded the neurosciences as the basis for neurosurgical training as well as neurosurgical activity. The reorganization of the neurosurgical institution coincided with the construction of a large modern building with state-of-the-art equipment for microneurosurgery, radiosurgery (gamma knife), neurodiagnostics, laboratories, etc. Many details of the construction plans, the equipment, and the organization of the department have their roots in the years that the present head of the department spent in the United States; this is also the reason for the close connection and cooperation of Vienna neurosurgery with many neurosurgeons in the United States.