The highly complex specialty of brainstem surgery requires many years of study, a focus on precision, and a passionate dedication to excellence to prepare the neurosurgeon for navigating significant anatomic challenges. Although the brainstem is technically surgically accessible, its highly eloquent structure demands rigorous surgical decision-making. An in-depth understanding of brainstem and thalamic anatomy and the safe entry zones used to access critical areas of the brainstem is essential to traversing the brainstem safely and successfully.