The aging population is a common challenge for SUDOE, and ensuring equitable access to quality care for the elderly requires the coordination and cooperation of involved actors to improve the care pathway. Neurosurgery deals with the surgical treatment of nervous system and spinal column diseases, and all European neurosurgery departments face the challenge of treating increasingly older and complex patients, as 50% of neurosurgical inpatients are over 65. Improving neurosurgical care for elderly patients is a shared challenge for all Europeans. It is necessary to better articulate geriatric and neurosurgical knowledge, as close as possible to local and transnational realities. Therefore, it is necessary to rethink the provision of an integrated care pathway for elderly neurosurgical patients, improving quality, cooperation, and coordination, as well as the meaning of care, in close collaboration with local geriatric teams. The main objective of GENEUS is to ensure equal access to neurosurgical care for the elderly by deploying an integrated geriatric neurosurgical care pathway as close as possible to local needs. To this end, a pragmatic territorial assessment of elderly patients in SUDOE neurosurgery departments will be carried out, followed by the development of a quantifiable operational solution in the form of a toolbox that will be deployed as an integrated geriatric neurosurgical care pathway throughout the region. Finally, a medical and economic study will be conducted. The objectives of GENEUS are i) to harmonize care scenarios for elderly patients hospitalized for neurosurgery in the three SUDOE regions, ii) to deploy a toolbox for each project beneficiary, before, during, and after hospitalization, and iii) to ensure that this new care pathway is adopted by hospitals, health authorities, and scientific societies in each country.