Aim:Neurosurgery is a demanding speciality in medical field. The training in neurosurgery requires persistent passion, dedication and laborious effort to obtain the required professional knowledge, stay updated on the recent advances, better the clinical decision making, upgrade surgical skills and apply all this to satisfy the patient’s expectation. Our study aims to assess the real challenges faced by neurosurgery residents in developing countries with limited resources and massive workload.Material and Methods:It’s a cross-sectional study based on the questionnaire filled by the neurosurgery trainees in Pakistan directed at their training, stress factors, surgical competency, research interest, job satisfaction and future endeavors. Results:Total 75 neurosurgery residents participated in study, 73.3% were male. About 61.3% were working for more than 72 hours per week. Average sleeping hours per day were less than seven hours for 92% trainees. Only 78.6% were able to receive teaching sessions for at least once a week or more. Practical handling of neurosurgical gadgets like microscope and endoscope was never experienced by 26.7% and 18.7%, respectively. Even the senior most residents were able to perform only 41.08% of their surgeries independently. Financial support was only acceptable to 21.3% and 60.9% want to leave the country upon completion of training. Conclusion:The training programs in the developing countries need critical changes to provide favorable learning conditions with availability of appropriate surgical tools, structural changes of training programs, development of research interest and improvement on the socio-economic needs of the.