The new millennium beckons for novel advances in the diagnosis and treatmen
t of pediatric neurosurgical conditions. Almost every aspect of pediatric n
eurosurgery has changed over the last decade. Undoubtedly with the applicat
ion of knowledge in molecular biology to human disease many aspects of neur
osurgery, especially neuro-oncology and the field of neuro-developmental an
omalies, will change appreciably over the next decade. Overall, the trend i
n surgery in general and neurosurgery in particular is toward less invasive
procedures and possibly non-surgical interventions. This review will brief
ly cover many of the important areas of pediatric neurosurgery. We will des
cribe the state-of-the-art of our subspecialty and discuss possible future
directions.