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ObjectivesChinese neurosurgery has made great progress during the past decades; yet, little is known about the working status of neurosurgeons. This study aimed to evaluate the difference between academic and non-academic neurosurgeons, focusing on their professional burnout, job satisfaction and work engagement.DesignCross-sectional nationwide survey.Study settingThe survey was conducted in China between 2017 and 2018.ParticipantsA total number of 823 academic neurosurgeons and 379 non-academic neurosurgeons participated in this study.Outcome measuresProfessional burnout, job satisfaction and work engagement were assessed using the Maslach Burnout Inventory, the Job Descriptive Index and the Utrecht Work Engagement Scale, respectively.ResultsThe majority of respondents were male (92.93%), less than 45 years old (85.27%) and married (79.53%). Chinese neurosurgeons worked 63.91±11.04 hours per week, and approximately 45% experienced burnout. Compared with non-academic respondents, academic neurosurgeons had longer working hours (pConclusionChinese neurosurgeons are under significant stress particularly for the non-academic neurosurgeons. Offering better opportunities for training, promotion, higher income and safer working environments could be solutions to relieve burnout and improve career satisfaction and engagement.Trial registration numberChiCTR1800014762. This article is not linked to a clinical trial.