Objectives We set out to study the nature of successful litigation claims in order to inform neurologists and neurosurgeons about hazardous areas within their specialties and potentially alter clinical practice.

Design Nationwide retrospective analysis of successful neurology and neurosurgery claims over a 17-year period.

Setting We studied all successful claims occurring between 1995 and 2012 using the NHS Litigation Authority database, which collects data on claims made against clinicians practicing in England and Wales.

Participants 423 successful claims were identified during the study period.

Main outcome measures The errors involved, the patient groups affected, the resulting mortality and the litigation payments.

Results Missed diagnosis was the most common cause of litigation, followed by negligent performance of a procedure. Cerebrovascular disease and intracranial tumours were the most frequently missed diagnoses. Litigation payments were significantly higher in neurosurgery compared to neurology cases.

Conclusions This is the first study of successful litigation claims against the NHS for negligent neurological or neurosurgical care and provides data to help reduce risk and improve patient safety.