Although neurological disease has been recognized since antiquity, neurology as a systematic clinical discipline is less than 130 years old. Neurological practice has traditionally been constrained by the complexity of the human nervous system, which has been slow to yield its secrets. Over the last three decades, however, clinical neurology has been transformed in terms of both diagnostics and therapeutics and now marches in lockstep with the cutting edge of medicine. Efficacious treatments are now available for the majority of neurological diseases, including epilepsy, migraine, Guillain-Barre syndrome, Parkinson's disease, multiple sclerosis, and ischemic stroke. This neurological revolution has been enabled by advances in neuroimaging and through the integrated application of basic research, drug development, biotechnology and clinical trial methodology. Neurology in the 21st century is a dynamic specialty offering relief and benefit to many patients, and holding the promise for one day conquering neurological disease in all its manifestations.