INTRODUCTIONThis work is based on the 34 years own experiences of realization stereotaxic operations at the patients with extrapyramidal pathology. During 1988 - 2022 years were performed 1†2 operations to 131 patients with Parkinson's disease, cerebral palsy and various hyperkinesias. In all cases the indication to surgical treatment was unsuccessful pharmaceutical treatment not less than 2-3 years.MATERIAL AND METHODSThe operations were carried out in specialized stereotaxic X-ray operation room, wich was shielded from electromagnetic and x-ray radiation. Operational is equipped with stereotaxic system of an own design, stationary X-ray device, electroencephalograf, electrostimulator, and videomonitoring system. Specific own design devicyes are cryodestructor, intracerebral chronic electrodes and chemoelectrodes . All operations are carried out with use local anesthesia at definite consciousness of the patient. For construction intracerebral coordinates system was applied long-focus X-ray grafia.Stereotaxic operation is multi steps procedure. It consist: the fixing of a head in stereotaxics device, choice a brain target, the constructions intracerebral coordinates system, spatial modeling of a target, introduction a diagnostic electrode and realization electrostimulation, electropolarization, introduction of anesthetics in subcortical target, X-ray control of accuracy of anatomic hit in the target and realizations of cryodestruction.Most frequently as a target we got out ventrolateral nucleus of thalamus, and subthalamus,field of Forel H1.The special importance have a mechanical accuracy of stereotaxics device, accuracy of X-ray method of construction intracerebral coordinates system , functional and X-ray control of cryodestructors hit in the necessary subcortical structure, clear consciousness, and high-grade speech contact to the patient,RESULTSThe results of research prove high efficiency of venterolateral thalamotomy at the patients with drug resistance extrapyramidal diseases. So we have got 71 % good and 14 % of satisfactory results at the Parkinsonians patients. More than half case good results at the cerebral palsy patients and 81% good results at the patients with subcortical tremorCONCLUSIONSOur experience showed that venterolateral of thalamus and subthalamic nucleus is an universal stereotaxic target for many extrapyramidal diseases.Stereotactic destruction of the subcortical nuclei is the simplest and most effective operation. And in terms of price-effectiveness ratio, it significantly exceeds the method of Deep Brain Stimulation.