Genetic engineering of neurotransmitter metabolic routes is important for the development of neurotransmitter-producing cells for the ex vivo gene therapy of many CNS diseases. Human neural stem cells (hNSCs) are excellent candidates to serve this role, but, for the case of Parkinson's disease, the cells do not normally express the rate-limiting dopamine (DA) synthesis enzyme tyrosine hydroxylase (TH), and are not equipped with the detoxifying mechanisms needed to prevent the neurotoxicity associated with the DA phenotype. In this study we have examined the capacity of hNSCs for ectopic expression of human TH. High-level TH expression (from viral promoters) leads to growth arrest and hNSC death (associated with an increase in p53 expression and nuclear fragmentation), which can be counteracted by treatment with a pan-caspase inhibitor. As a consequence, stable TH-expressing hNSC sublines could not be derived using viral promoters. In contrast, moderate TH expression (from a human housekeeping promoter, polyubiquitin gene), allows for stable TH+ subclone derivation, seemingly originating from low-expressing cells. Our results are thus compatible with the view that stable TH-expressing hNSC lines can be generated if TH expression levels are kept at a moderate level, and that the goal normally set of aiming at high-level TH expression may need to be reconsidered. These results may be relevant for the generation of TH/DA-producing human neural cells for in vitro and neurotransplantation research in Parkinson's disease.