Intraoperative neuroimaging has significantly advanced in recent years, yet intraoperative neurophysiology continues to play a vital role in the precise placement of electrodes for deep brain stimulation (DBS). This chapter explores the two key components of intraoperative neurophysiology: microelectrode recording (MER) and macrostimulation. These techniques offer critical real-time feedback that enhances the accuracy of electrode placement, especially when accounting for brain shift, or “sag,” caused by cerebrospinal fluid release during surgery. We consistently observe a subtle discrepancy between the imaging data and actual anatomy, with the lower border of the DBS target being approximately 1–2 mm deeper than anticipated. Additionally, we highlight the emerging potential of chronic field potential recordings from DBS systems as a promising tool for future clinical and research applications. The inclusion of both MER and macrostimulation in DBS procedures improves precision, providing greater confidence in electrode placement for optimal patient outcomes.