The results of stereotactical thalamotomy in 40 adult patients suffering from tremor of different etiology are presented. A combination of lesions of VOA-VOP-ZI seems to be optimal. Early results have been excellent in 63%, good in 23%, fair in 6% and poor in 8%. Long-term follow-up showed a negative shift with 40% excellent, 6% good and 54% poor results. In Parkinson disease with predominant tremor relief of this invalidating symptom can be achieved. But L-dopa therapy must be continued and surgical treatment does not stop the general disease progression.