AFTER 3 YEARS of deliberations, The Society of Neurological Surgeons approved a national Neurological Surgery Matching Program in 1983 for residency positions beginning July 1, 1985. All directors of United States neurological surgery residency training programs agreed to participate and abide by the rules of the match. A review of 10 years' experience with 11 matches from 1983 to 1994 indicates full acceptance by both applicants and program directors and a highly successful process and outcome, satisfactory for everyone except for qualified applicants who failed to obtain a residency position. Since 1985, 1455 neurosurgical (Postgraduate Year 2) residency positions have been offered for match, and 2708 applicants have submitted a ranking list, filling 1434 positions with the initial computer run each year and leaving 1274 unmatched applicants. Thus, the ratio of applicants to available positions is almost 2:1. Various interesting details about multiple-year applications, International Medical Graduates, and nonstart, transfer, and dropout rates are presented, including the eventual practice activities of residents not completing neurosurgical training. A comparison of all United States medical schools, considering data on applications and matches for neurosurgical residency versus number of senior medical students, reveals wide differences. These differences are probably related to the availability of neurosurgical clerkships, faculty participation in the undergraduate curriculum, and the presence of a neurosurgical residency program.