Sir Charles Ballance was an English surgeon with a long career and surgical endeavours at the St Thomas Hospital (London, England) and National Hospital, Queen Square. He was a multifaceted man, holding various adjunctive appointments throughout his profession including colonel posting for the Army Medical Service in Malta (WW1) and principle surgeon to the Metropolitan Police. Sir Charles Ballance contributed many firsts within the field of neurosurgery. This includes and is far from limited to successful total excision of cerebellopontine angle tumour, facial nerve anastomosis, and first to understand the signs of cerebellar abscess localization. His endeavours were also collaborative with lifelong colleagues including Charles Beevor, Charles Sherrington and Victor Horsley. One well acknowledged collaborative success is that of a removal of extramedullary spinal cord tumour with Horsley. Despite his repute as a impractically meticulous and maybe pompous surgeon, his operative experience amassed over 400 supra- and infra-tentorial brain lesions and 75 original publications. He was a academic, researcher and surgeon with a passion to advance the finesse of surgery, embodying the competences of a surgeon. Unfortunately, his contributes have been frequently overshadowed by the asimilar endeavours of famed colleague, Horsley. Ballance was more or less acknowledged as the ‘second pioneer British neurological surgeon’ despite chronological congruity to Horsley. The author pays homage to the RACS Cowlishaw collection through reflection on the biography and neurosurgical endeavours of Sir Charles Ballance as it pertains to his landmark book, Surgery of the brain and some of its membranes (1907).