The needle electromyographic (EMG) examination is a challenging component of the electrophysiologic study. Knowledge of anatomy and physiology, sound EMG technique, and good patient rapport are required. Every muscle sampled by needle EMG is assessed for insertional activity, spontaneous activity, and voluntary motor-unit action potentials. Key pieces of information obtained from the needle EMG examination include the localization of the disorder, its chronicity, severity, and whether or not the underlying pathophysiology is neuropathic, myopathic, or associated with a neuromuscular junction disorder.