<p>Gait impairments are among the most debilitating symptoms of neurological disorders. Abnormalities such as freezing of gait, weakness (paresis or paralysis) and imbalance remain resistant to standard treatments and severely restrict mobility, independence and quality of life. Although deep brain stimulation is highly effective for many motor symptoms, its benefits for gait and balance have been inconsistent. Emerging brain and spinal neuromodulation strategies across neurological disorders highlight the need for more distributed and adaptive approaches that better engage the neural circuits underlying locomotion. Next-generation neurotechnologies support this shift, incorporating algorithms that leverage anatomical, electrophysiological and movement-related feedback to optimize contact selection and adapt stimulation in real time. Together with a growing understanding of neural mechanisms of gait dysfunction across disorders, these multifaceted approaches are enabling targeted interventions that account for spatial and temporal dynamics of gait control. In this Review, we highlight recent advances in neuromodulation for gait impairments, focusing on freezing of gait, weakness and imbalance across parkinsonian disorders, spinal cord injury, stroke and cerebellar ataxia. We propose a conceptual framework for tailoring neurotechnologies to gait dysfunction, mapping disrupted gait subcomponents and their neural substrates to targeted stimulation with spatiotemporal precision, integrating mechanistic and technological principles across aetiologies. Finally, we outline key priorities for clinical translation.</p>