Is there still a role for neurosurgery in psychiatry in 2015?Proof-of-concept work by a Korean team1 assessed a novel,minimally invasive, non-cranium-opening technique in four patients withrefractory obsessive–compulsive disorder (OCD). With just local anaestheticto the scalp, magnetic resonance-guided focused ultrasound (MRgFUS) wasutilised to thermally ablate the anterior limb of the internal capsulebilaterally. Unlike many other invasive procedures, this neuroimagedtechnique affords real-time monitoring of lesion induction and the patient'sneurological and psychological status. The treated individuals showed agradual improvement in their OCD, with mean symptom reductions of about athird over the 6-month follow-up period, and almost immediate and sustainedimprovements in depressive and anxiety symptoms. No neuropsychiatricsequalae were seen in this limited sample, which certainly comparesfavourably with existing techniques. Psychosurgery evokes unsavoury imagesof the past, and it is uncertain how much will there is for such work: in anevidence-based profession, let the data lead.