Background: Access to neurosurgical care is vital for conditions such as traumatic brain injuries and brain tumours. However, significant disparities in healthcare access persist in Canada, disproportionately affecting rural, Indigenous, and socioeconomically disadvantaged populations. This qualitative scoping review examines barriers and facilitators to neurosurgical access, addressing gaps in the literature concerning equity-deserving groups. Methods: A systematic literature search (2000–2024) was conducted within MEDLINE, EMBASE, Cochrane Library, PsycINFO, and Scopus, along with gray literature from governmental and non-governmental organizations. From 1400 identified records, eight qualitative or mixed-methods studies met the inclusion criteria. Thematic analysis was conducted to explore socioeconomic, geographic, racial, gender-based, and cultural barriers. Results: Four major themes emerged: delays in access, alternative healthcare options, policy barriers, and communication and coordination issues. Barriers such as transportation gaps, socioeconomic inequities, and systemic discrimination were particularly pronounced for rural and Indigenous populations. Facilitators like telehealth and improved inter-hospital coordination show potential but are limited by infrastructure constraints and cultural misalignments. Conclusions: Addressing barriers to neurosurgical care requires systemic reforms, including equitable resource allocation, expanded digital infrastructure, and culturally competent care. The lack of intersectional research on overlapping barriers underscores the need for future studies to prioritize tailored interventions to ensure timely, equitable neurosurgical care across Canada.