Microneurosurgery made its debut in the early 1960s. It became popular in the medical field and became a primary operation method in neurosurgery since it improved the efficacy of neurosurgery with a less surgery?related injury. Over the past five decades, the accumulation of experience of microsurgery, improvement of microsurgery techniques, refined micro?instruments, and advanced preoperative diagnostic imaging allowed the evolution of microneurosurgery techniques and further reduced surgery?related trauma. The advanced development has made it possible for a neurosurgeon to treat more sophisticated lesions with smaller craniotomy. Keyhole neurosurgery, the combination of mod microsurgical techniques, preoperative imaging, neuroendoscopy, and mod minimally invasive surgery concept, is one of the techniques representing the medical advancement from microneurosurgery to minimally invasive neurosurgery.