The off-service rotation in Neurosurgery is included in some programs training emergency medicine residents. It may also be offered as an elective. The experience on this rotation can lack opportunity and educational content if structured guidance is not available. We have addressed this problem by developing a written curricula containing subject content listing, objectives, and references for the Neurosurgery off-service rotation for emergency medicine residents. This is the 23rd in a series of objectives for off-service rotations for emergency medicine residents.