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¹İstanbul Üniversitesi Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye From its very beginning, neurosurgery appeared to offer the most logical therapy for "intractable pain" because of its potential ability to directly interrupt pain"s afferent nociceptive pathways. At one time or another, almost every type of pain has been treated by some form of neurosurgical procedure based on the simple notion that blocking pain"s pathways, by either ablation or neuromodulation, would prevent transmission of its signals into consciousness. The essential criterion of pain justifying a neurosurgical treatment is its intractable character. Although the severity of the pain experienced by the patient is often obvious to the clinician, evaluation of pain"s intensity requires a battery of "objective" tests that make use of visual and psychological scales. Neurosurgeons distinguish 2 categories of surgery: "ablation" or "neuromodulation." Neuromodulation may be either electrical or chemical. Peripheral Nerve, Spinal Cord, Deep Brain and Motor Cortex Stimulations are the leading applications. The principal ablative procedures include percutaneous rhizotomy; midline myelotomy; cordotomy; and, among the intracranial ablations, cingulotomy and procedures aimed at the Gasser ganglion for trigeminal neuralgia or cluster headache. Recent clinical studies have emphasized the importance of applying energy to neural structures in neuromodulation therapies. Anahtar Kelimeler : Neurosurgery, Neuromodulation, Ablation, Pain surgery, Recent treatment