The use of live televised surgery (LTS) has evolved significantly over recent years. It has usually been organized by a surgical society at a meeting to demonstrate surgical techniques to a large number of members or attendants. This allows examination of surgical techniques, tips, and decisions in a real-time fashion and management of unexpected events such as surgical complications. However, notwithstanding the obvious educational benefits, there has been an increasing awareness that surgery performed under these conditions presents a number of unique ethical considerations. These include patient-centered issues such as privacy, consent, and possible harm, and surgeon-related issues such as impaired performance due to distraction. Finally, there may be participant-related issues regarding the advantages or disadvantages of this type of medical education over and above other types or medical education. Currently there are no specific guidelines for the use of LTS in neurosurgery, and the time may have come for this to be considered.