Background: The optimal mode for perioperative prophylaxis of deep vein thrombosis in neurosurgery is yet unclear. Objective: To outline the mode of deep vein thrombosis prophylaxis. To find out about the assessment of risk and benefit of perioperative heparin application. Methods: For intracranial and spinal procedures routine measures for prophylaxis of deep vein thrombosis were inquired from 130 departments as well as subjective assessment of therapeutic effect and risk of heparin application. Results: Most departments make use of antithrombotic stockings and low molecular weight heparins. A majority starts on the day before surgery or soon thereafter. Only when begun early on, heparin is supposed to have a benefit in all procedures, whereas risk increase is regarded as high only in intracranial procedures. Conclusion: Only in spinal procedures a standard has evolved. Registering complications at departments with varying strategies for deep vein thrombosis prophylaxis could yield a standard in intracranial surgery.