As the population ages, the number of people with Parkinson’s disease is increasing. The treatment for Parkinson’s disease is either medication or surgery. In my outpatient work, the most common question I encounter from patients is whether we should have surgery and when is the most appropriate time to have surgery? I will discuss a few of my own views on this issue. First, I believe that as long as the disease is primary Parkinson’s disease, surgery should be used if economic conditions allow. As for what kind of patients belong to primary Parkinson’s disease, there are detailed descriptions in my other scientific articles. Secondly, I believe the best time to operate is when the patient is experiencing side effects of the medication, i.e., significant “on/off” phenomena and allodynia. This side effect cannot be completely resolved by the adjustment of the medication itself. This should be the best time for surgery. Third, in addition to the condition of the patient, we must also consider the patient’s age and general condition. If the patient is not in good general health and is older (>70 years old). I suggest that it is better to operate earlier, otherwise there is a risk of losing the best time for surgery and increasing the chances of surgical risks. Fourth, is the earlier the surgery, the better? I myself think not exactly, because there is difficulty in identifying early Parkinson’s disease and Parkinson’s disease syndrome, and there is no way to resolve swallowing and speech problems as well as balance disorders by adjusting stimulation parameters after Parkinson’s disease syndrome surgery. It can add unnecessary conflicts between doctors and patients. Finally, I would like to emphasize one more point, if the diagnosis of Parkinson’s disease is clear it is still important to operate as early as possible. This will improve the patient’s symptoms, improve the quality of life, and slow down the progression of Parkinson’s disease. Do not wait until the patient is unable to move and is in a wheelchair before you remember to have surgery. I’m afraid surgery won’t solve the problem then.