In November 1991, the American Speech-Language-Hearing Association formally adopted the position that neurophysiological intraoperative monitoring (NIM) is within the scope of practice of audiology. This article relates to the scope of practice extension in several ways. NIM is defined and described in a manner that presents the comprehensive nature of its application. A developmental review of NIM relates the role played by individual audiologists and audiology as a discipline. This includes a rationale for audiologists as NIM practitioners. The section about the clinical practice of intraoperative monitoring overviews methodologies and is highlighted by case examples. Finally, education, training, research, and reimbursement are underscored as future needs for this specialty area.