We report the case of a 69-year-old man with severe Tourette's syndrome (TS) who underwent a bilateral prefrontal leucotomy at the age of 29 years to alleviate coprolalia, copropraxia, and obsessive-compulsive disorder. No improvement was observed during the 5 years after the leucotomy. Tics and associated behavioral abnormalities disappeared thereafter, to recur at age 67. Long-term follow-up of single cases can help to estimate the role of neurosurgery in the treatment of TS.