For many years, neurocysticercosis has been an important concern for neurosurgeons in developing countries, particularly in Asia, Africa, and Latin America, and there is also an important body of literature from the aforementioned geographic areas. Surgery has always been considered a symptomatic treatment for this parasitic disease; nevertheless, the most important contributions have been developed in the last 2 decades, and diagnosis has been greatly improved with the use of computed tomography (CT) since the late 1970s and magnetic resonance imaging (MRI) since the late 1980s. Concurrently, enzyme-linked immunosorbent assay (ELISA) and Western blot techniques for the immunologic diagnosis of neurocysticercosis were introduced and continue to be extremely useful because of their high sensitivity. During the previous 4 decades, 237 patients with neurocysticercosis were operated on at this institution and 494 different types of surgical procedures were performed. Because diagnosis is easier nowadays using the aforementioned techniques (ELISA, Western blot, CT, and MRI), there were only 52 cases during the period from 1994 to 2003. Many patients were treated by neurologists or general practitioners. The racemose form of cysticercosis was present in almost half of the total cases. Cranial hypertension was the most common clinical form; for this reason, 43 of 52 cases required a cerebrospinal fluid shunt, and 27 of 43 shunts were placed as single surgical procedures. Craniotomy was required in only 10 cases, and 12 patients were treated using neuroendoscopic methods. It was confirmed that neuroendoscopy is a useful technique for treating intraventricular cysticercosis, and cysts and membranes were excised in 9 cases. Third ventricle fenestration was performed in 5 cases. In 3 cases, it was necessary to perform a septum pellucidum fenestration. Because the ventricular localization of cysticercosis is quite frequent (27 cases), the intraventricular approach using neuroendoscopic techniques is strongly supported.