Cingulotomy can be helpful in certain patients with severe, disabling, and treatment-refractory major affective disorders, OCD, and chronic anxiety states. This form of psychosurgical treatment should only be carried out by an expert multidisciplinary team with experience in these disorders. Cingulotomy should be considered as one part of an entire treatment plan and must be followed by an appropriate psychiatric rehabilitation program. Many patients are greatly improved after cingulotomy, and the complications or side effects are few. Cingulotomy remains an important therapeutic option for disabling psychiatric disease and is probably underutilized.