The problem of the transition from childhood to adulthood in Canadian neurosurgery results from the individuation of pediatric neurosurgery. Except for transition programs for specific diseases, such as spina bifida or neurofibromatosis or cerebrovascular diseases, which are followed by adult surgical-endovascular teams, the transition from pediatric to adult care is generally left to the initiative of patients and their family. This reflects both the organization of healthcare and the geographic specificities of Canada. A harmonious transition from childhood to adulthood should result from coordination between neurosurgeons and between the different hospital networks. Transition teams, such as those already in operation for spina bifida, should be expanded to other diseases. Patient associations have a key role to play in this change.