The Neurosurgery Research & Education Foundation (NREF) is celebrating its 40th anniversary this month. Since its inception, the NREF has invested nearly $30 million in the future of neurosurgery through its support of basic science and clinical research, as well as life-long education, to foster improved outcomes for our patients with neurosurgical diseases. See the article by Agarwal et al. (pp 1905–1912).