BACKGROUND: Artificial intelligence (AI) may favorably support surgeons but can result in concern among patients and their relatives. The aim of this study was to evaluate attitudes of patients and their relatives regarding use of AI in neurosurgery. METHODS: In a 2-stage cross-sectional survey, a qualitative survey was administered to a focus group of former patients to investigate their perception of AI and its role in neurosurgery. Five themes were identified and used to generate a case-based quantitative survey administered to inpatients and their relatives over a 2-week period. Presented AI platforms were rated appropriate and acceptable using 5-point Likert scales. Demographic data were collected. χ2 test was used to determine whether demographics influenced participants' attitudes. RESULTS: In the first stage, 20 participants responded. Five themes were identified: interpretation of imaging (4/20; 20%), operative planning (5/20; 25%), real-time alert of potential complications (10/20; 50%), partially autonomous surgery (6/20; 30%), and fully autonomous surgery (3/20; 15%). In the second stage, 107 participants responded. Most thought it appropriate and acceptable to use AI for imaging interpretation (76.7%; 66.3%), operative planning (76.7%; 75.8%), real-time alert of potential complications (82.2%; 72.9%), and partially autonomous surgery (58%; 47.7%). Conversely, most did not think that fully autonomous surgery was appropriate (27.1%) or acceptable (17.7%). Demographics did not have a significant influence on perception. CONCLUSIONS: Most patients and their relatives believed that AI has a role in neurosurgery and found it acceptable. Notable exceptions were fully autonomous systems, with most wanting the neurosurgeon ultimately to remain in control.