Empathy is a basic core human characteristic, the foundation for social relationships and interpersonal attachment. In medicine, particularly in neurosurgery, empathy goes beyond the concept of clinical neutrality and emerges as a guiding philosophy to form patient-centered care. Neurosurgical patients, who are often handling complex, life-changing pathologies, benefit greatly from empathetic reassurances that diminish their anxiety and establish a more robust patient-clinician connection. However, constructs of modern healthcare that undermine empathy include the very high value placed on time, oppressive workloads, inadequate staffing, and performance-driven cultures that can reduce compassion to nothing more than a secondary concern. The evidence underscores that empathy helps to improve patient satisfaction, treatment adherence, and development of strong therapeutic alliances. An empathic practice also helps the clinician in being protective against burnout, building emotional resilience, and the induction of reflection in self-assessment-all beneficial for his or her mental health. Indeed, another obvious and serious decrease in empathy has been detected with the increasing years of training in trainees and practitioners, as well as in clinical environments. The institutions need to have adequate staffing, the best flow processes, and empathetic leadership from the front, really prioritizing emotional well-being. Teaching empathy in medical school and during residency is critical, so our future physicians understand its importance. Empathy is further consolidated by ongoing professional training in communication skills and emotional intelligence and self-care strategies. Neurosurgery, as a high-demand and tough surgical discipline, can benefit the most from a culture of empathy.