Minimally invasive neurosurgery has developed rapidly in the past 20 years. The core concept of minimally invasive neurosurgery is minimally invasive – especially for brain tissues and neurovascular, which is minimally invasive based on the maximum protection of normal tissue function. It is true that training in microscopic operating techniques can foster better minimally invasive surgical techniques, but thinking determines practice, and the most critical aspect of minimally invasive neurosurgery implementation is the cultivation and establishment of a scientific minimally invasive concept. Minimally invasive neurosurgery consists of five main areas: (1) micro-neurosurgery, (2) stereotactic and functional neurosurgery, (3) endoscopic neurosurgery, (4) endovascular neurosurgery, and (5) radiation neurosurgery. Undoubtedly, small incisions and small bone windows are in line with the principles of cosmetic and minimally invasive, but the real and most important minimally invasive concept of our neurosurgery refers to the minimally invasive brain tissue and brain function. Excellent equipment and skillful microscopic operation techniques are necessary for most neurosurgical procedures, including foramen ovale surgery, but those who emphasize minimally invasive scalp and bone windows without paying attention to microscopic operation techniques, and do it reluctantly when the surgical conditions are not available, can only aggravate brain damage and even cause brain dysfunction, which causes serious consequences. This is a misconception of “minimally invasive”. Only a training mode that combines the promotion of minimally invasive concepts and minimally invasive techniques can truly implement the spirit and concept of minimally invasive. At present, neurosurgical diseases are in line with minimally invasive incisions, such as the brow arch approach, additional lateral approach, and transnasal butterfly surgery. All of them are small surgical incisions. These surgical approaches are in line with the concept of minimally invasive cosmetic surgery. The true meaning of minimally invasive surgery is understood if the surgical operation is performed with the concept of minimally invasive surgery to protect nerve function, brain tissue and other important outcomes, reduce injury and strain, and reduce the patient’s postoperative reaction and complications. At this point of writing, I hope to answer the questions of the majority of patients and not to be blinded by minimally invasive. Nowadays, many medical institutions play the banner of minimally invasive, but in fact, in many cases, they take advantage of the patient’s psychology to enlist the patient, which does not really bring real surgical results and relieve the pain. It is only true to know right from wrong. Minimally invasive neurosurgery has developed rapidly in the past 20 years. The core concept of minimally invasive neurosurgery is minimally invasive – especially for brain tissues and neurovascular, which is minimally invasive on the basis of maximum protection of normal tissue function. It is true that training in microscopic operating techniques can foster better minimally invasive surgical techniques, but thinking determines practice, and the most critical aspect of minimally invasive neurosurgery implementation is the cultivation and establishment of a scientific minimally invasive philosophy. Minimally invasive neurosurgery has developed rapidly in the past 20 years. The core concept of minimally invasive neurosurgery is minimally invasive – especially for brain tissues and neurovascular, based on the maximum protection of normal tissue function. It is true that training in microscopic operating techniques can foster better minimally invasive surgical techniques, but thinking determines practice, and the most critical aspect of minimally invasive neurosurgery implementation is the cultivation and establishment of a scientific minimally invasive philosophy.