The field of neurosurgery stands at the precipice of a transformative era, driven by the rapid evolution of artificial intelligence (AI). From optimizing patient selection and surgical parameters to enhancing intraoperative precision, AI has already begun to reshape the landscape of neurosurgical care. Yet, as these technologies advance from preclinical studies to real-world applications, the challenges of responsible integration, evaluation and safety have become increasingly urgent.This groundbreaking textbook equips neurosurgeons with the foundational knowledge to navigate the complexities of AI in clinical practice. It explores the remarkable progress of AI systems, from machine learning-enhanced neuronavigation to agentic systems capable of autonomous, multistep workflows. With a focus on real-world clinical data, fairness and interpretability, the book addresses the critical hurdles of evaluation lag, dataset curation and regulatory oversight.As AI transitions from passive tools to active participants in medical problem-solving, this text provides a roadmap for neurosurgeons to lead the charge in developing, implementing and critically assessing these transformative technologies. By bridging the gap between innovation and practice, this book ensures that the next generation of neurosurgeons is prepared to harness the full potential of AI while safeguarding patient care.