Globally, a large deficit of neurosurgeons exists along with a growing burden of disease requiring neurosurgical care. Also, considerable geographical disparities remain in the neurosurgical workforce distribution. Augmenting and diversifying the neurosurgical workforce requires addressing barriers which deter medical students and unspecialized residents from pursuing a neurosurgical career. Current studies have largely investigated these challenges on a national scale. Investigation into barriers to a neurosurgical career from a global perspective has been limited. Identifying these barriers across high- and low/middle-income countries is critical to recruiting a more robust neurosurgical workforce and reducing global disparities in access to neurosurgical care. We conducted a systematic review to identify perceived barriers encountered by medical students and unspecialized residents to pursuing a neurosurgical career worldwide. We compared studies performed in high- versus low/middle-income countries and identified shared challenges related to gender stereotypes, work-life balance, academic rigor, and financial compensation. Our findings form a basis for formulating global solutions to augment the neurosurgical workforce.