The objective of this study was to determine the prevalence of diversity, equity, and inclusion (DEI) information on neurosurgery residency program websites and examine the association between program size, ranking, and DEI information presence. A cross-sectional review of 115 US neurosurgery residency program websites was conducted from January 1 to March 2, 2024. Websites were evaluated based on six DEI criteria: 1) diversity commitment in mission/leadership statements, 2) separate diversity mission statement, 3) rotations/fellowships for underrepresented minority students, 4) diversity initiatives, 5) diversity page/section, and 6) appointed diversity leadership positions. Associations between program size, ranking, and DEI information were analyzed. Among the 115 programs, only 35 (30.43%) met at least one DEI criterion. Specifically, 18.26% had a separate diversity mission statement and 15.65% included a DEI statement in mission/leadership messages. Programs with more than 13 residents were significantly more likely to meet at least one DEI criterion (OR 2.96, 95% CI 1.16-7.56; p = 0.022) and to include a DEI statement in mission/leadership messages (OR 5.38, 95% CI 1.71-24.72; p = 0.018). Top 25-ranked programs by U.S. News & World Report were more likely to have diversity initiatives (OR 6.23, 95% CI 1.78-23.97; p = 0.007). Programs meeting any DEI criterion had a higher percentage of female (29.67% vs 22.55%, p = 0.013) and Black (7.85% vs 4.49%, p = 0.019) residents. There was no statistically significant difference in the percentage of White residents (p = 0.206) across programs, and programs with a mention of DEI in the mission statement had a lower percentage of Asian residents (24.08% vs 33.29%, p = 0.042). Most US neurosurgery residency programs lack DEI information on their websites. Larger programs and those with higher rankings are more likely to include DEI content, particularly standalone statements. Programs meeting DEI criteria tend to have a higher representation of female and Black residents. These findings highlight the need for greater transparency and commitment to DEI in neurosurgery residency programs, ensuring prospective applicants have access to comprehensive DEI information.
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