OBJECTIVE: The Korean government has legislated for Medical Dispute Mediation Act in 2011. As a member of medical accident appraisal board, the medical doctor should have well-balanced mind along with the thorough knowledge and experiences on his specialty. METHODS: We evaluated precedents related to the medical accidents of neurosurgery in Korea. We searched precedents in the Korean Supreme Court web site. There were 60 suits of damages in 108 precedents related to the neurosurgery from 1978 to 2010. We found 23 precedents related to neurosurgical treatment. RESULTS: Doctors or medical institutions were liable for damages in 12 precedents including 4 cases of partial responsibility such as solatium. In 11 precedents, liability for damages was disclaimed. The judgment was unrelated to the level of court, dead or disabled, main issue (11 medical error, 7 explanation, 5 negligence and others), or methods of treatment. Liability for damages was usually disclaimed (6 : 2) in 1980s, more frequently claimed (1 : 7) in 1990s, and it became almost same (4 : 3) in 2000s. CONCLUSION: Medical accident appraisal board should be fair in explorations of the accidents. We should prepare to get an expert medical investigator, who has balanced mind, knowledge on the law, and specialized knowledge with experiences on his specialty.