Despite over half of medical students in the United Kingdom (UK) being female, women represent only a small proportion of the workforce in the traditional “male” specialties, including neurosurgery. There is increasing global attention to and awareness of gender discrimination in the workplace across several industries, including health care. The authors set out to explore the opinions and attitudes of UK neurosurgeons and neurosurgery trainees on gender issues via a large-scale national survey. The results highlight key perceptions and gaps in mentorship and leadership and provide ideas for change. This should be used as a foundation to delve deeper and to address specific questions in order to achieve a fairer, more meritocratic environment in which neurosurgeons can thrive.