OBJECTIVE: The number of pediatric neurosurgeons worldwide remains inadequate. Opportunities for fellowship training and continuing medical education in pediatric neurosurgery are limited, particularly for neurosurgeons in low- and middle-income countries. This study aimed to describe the setup and conduct of a recurring online meeting to discuss diagnostic and treatment dilemmas in pediatric neurosurgery, organized by a group of pediatric neurosurgeons in Southeast Asia. METHODS: Available meeting reports since inception in 2022 and registration data for the year 2024 were analyzed. Meeting recordings were reviewed to describe the cases presented for opinion. A focus group discussion was conducted among core team members to evaluate the virtual meetings. RESULTS: From January 2022 to August 2024, the Southeast Asian pediatric neurosurgery group organized 16 online meetings to discuss 50 patients. Based on the report for 12 meetings (75%), the mean number of participants for each session was 45 ± 11, with 91% ± 5% of the attendees being present for at least 15 minutes. Review of 2024 registration data showed that 142 unique participants from 15 countries attended the 5 meetings for this year. Most were neurosurgery residents (65%) and neurosurgery consultants (23%). Of 50 cases presented, the majority were tumors (52%) and craniofacial disorders (16%). Discussions centered on most probable diagnosis (34%), best treatment option (90%), and recommended surgical approach (82%). CONCLUSIONS: International case discussions in pediatric neurosurgery are feasible and sustainable online, with the potential to improve service delivery, strengthen the workforce, and grow professional networks. Leadership and time commitment from a core group are essential to ensure the success of these global neurosurgery collaborations.