Since its original conception in 1959, the notion of nanotechnology and its potential ramifications have not only created fascination, but also intense scientific effort and scrutiny. Currently, research activities are being principally conducted in mesoscale, the realm between nanoscale and macroscale, with the rudiments of nanoscience being defined in realities and principles that will determine activities and discoveries in the future. This paper reviews and discusses the evolution of nanoscience, its contemporary status, and the discoveries that currently constitute the main components of the body of knowledge from a neurosurgical perspective. Specific attention is given to the developments in imaging, fabrication, nanostructures, nanoelectromechanical systems, molecular manufacturing, nanocomputation, and emerging physical and chemical concepts in mesoscale, as they will establish foundations for the realization of nanomedicine and nanoneurosurgery.