Where are all the neurosurgery robots?

Despite substantial advances in engineering, robotics, and artificial intelligence, autonomous robots have yet to revolutionize neurosurgery. In this perspective, we examine why neurosurgical robotics lag behind, analyzing economic, regulatory, liability, and cultural hurdles limiting their adoption. Drawing on our collective experience using robotics across different neurosurgical subspecialties, we advocate for cautious optimism-embracing thoughtful integration of robotics to enhance, not replace, the neurosurgeon's critical judgment.