Programmed cell death (PCD) is an evolutionarily conserved contributor to nervous system development. In the vertebrate peripheral nervous system, PCD is the basis of the neurotrophic theory, whereby cell death results from a surplus of neurons relative to target and competition for neurotrophic factors. In addition to stochastic cell death, PCD can be intrinsically determined by cell lineage or position and timing in both invertebrate and vertebrate central nervous systems. The underlying PCD molecular mechanisms include intrinsic transcription factor cascades and regulators of competence/susceptibility to cell death. Here, we provide a framework for understanding neural PCD from its regulation to its functions.