Is there still a role for neurosurgery in psychiatry in 2015? Proof-of-concept work by a Korean team1 assessed a novel, minimally invasive, non-cranium-opening technique in four patients with refractory obsessive–compulsive disorder (OCD). With just local anaesthetic to the scalp, magnetic resonance-guided focused ultrasound (MRgFUS) was utilised to thermally ablate the anterior limb of the internal capsule bilaterally. Unlike many other invasive procedures, this neuroimaged technique affords real-time monitoring of lesion induction and the patient's neurological and psychological status. The treated individuals showed a gradual improvement in their OCD, with mean symptom reductions of about a third over the 6-month follow-up period, and almost immediate and sustained improvements in depressive and anxiety symptoms. No neuropsychiatric sequalae were seen in this limited sample, which certainly compares favourably with existing techniques. Psychosurgery evokes unsavoury images of the past, and it is uncertain how much will there is for such work: in an evidence-based profession, let the data lead.