• Viðar Róbertsson, Nathan A Shlobin, Hulda Magnadóttir, Kristinn R Guðmundsson, Ingvar H Ólafsson, Aron Björnsson, and Gail Rosseau.
• Department of Neurosurgery, University of Iceland Landspítali, Reykjavík, Iceland.
• World Neurosurg. 2022 Nov 1; 167: 283628-36.

BackgroundAlthough surgical conditions account for 32% of the global burden of diseases, approximately 5 billion people worldwide lack access to timely and affordable, surgical and anesthetic services. Disparities in access to surgical care are most evident in low- and middle-income countries, often resulting from a lack of surgical infrastructure. However, the establishment of surgical infrastructure, particularly for specialty surgical services including neurosurgery, is challenging in countries with small populations, irrespective of income classification, due to the distribution of high costs among a lesser number of individuals. One such nation is Iceland. Despite high-income status, high quality of life, literacy, and educational attainment, the population of Iceland has often lacked access to local neurosurgical care, with the establishment of the domestic neurosurgical system in 1971 and continued externalization of complex neurosurgical procedures to neighboring nations and neurosurgeons.MethodsA narrative review was conducted.ResultsThis article provides the first-ever examination of neurosurgery in Iceland. We discussed the history and the social, political, and economical contexts in Iceland. We examined the history of neurosurgery in Iceland, which provided brief biographic sketches of pioneers who have catalyzed the establishment of neurosurgical care and training in Iceland, and characterize the current state of neurosurgery in Iceland.ConclusionsRecommendations derived from the experiences of Icelandic neurosurgeons may guide the international community in future initiatives.Copyright © 2022 Elsevier Inc. All rights reserved.

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