Background: Despite being mandatory for accreditation by the RCPSC and ACGME, little is known about how ethics education is undertaken during neurosurgery training. This study assessed the current state of ethics education in North American neurosurgery training programs. Methods: A web-based survey was developed based on ethics competencies outlined by the RCPSC and the ACGME and emailed to North American neurosurgery residency program directors(PD’s). Responses were analyzed using descriptive statistics. Results: 47/119 (40%) PD’s completed the survey. Most(74%) spent <10 hours/year on ethics education. Informal discussion(86%), case presentations(67%) and lectures(55%) were common teaching methods. Most(85%) felt real-life experience was the best teaching method. Neurosurgical faculty(86% of programs), medical faculty(48%) and ethicists(26%) provided ethics teaching. Time constraints(42%) and lack of expert faculty(24%) were common barriers. Important topics were end of life care(95%), conflicts of interest(81%), informed consent(81%), futility(66%) and research ethics(66%). Most(78%) felt ethics education should be mandatory and that trainees were prepared to deal with ethically challenging situations(95%). Conclusions: This study provides a snapshot of ethics education in neurosurgery training. Time constraints and a lack of expert faculty were seen as barriers to ethics education. Most program directors felt residents were well prepared to deal with ethical issues. Identified ethical topics of importance should be incorporated into training curricula.