Background/Aim. In an era of rapid technological innovation and growing patient expectations, healthcare systems worldwide face the need for continuous improvement in service quality. The Service Quality model (SERVQUAL) is a validated instrument for measuring service quality, based on comparing patients’ expectations with their perceptions of the service provided. The difference (gap) between these two measures is assessed using a five-point Likert scale across five dimensions: tangibility, reliability, responsiveness, assurance, and empathy. The aim of this study was to measure and compare expectations and perceptions of patients undergoing neurosurgical services, and to examine whether the size of the gap differs between SERVQUAL dimensions. Methods. The study included a total of 60 patients who underwent surgery for degenerative lumbar and cervical spine diseases at the Clinic for Neurosurgery, University Clinical Center of Vojvodina, Novi Sad, Serbia, between June and September 2024. A modified SERVQUAL questionnaire was used for data collection. Data were collected on admission and before the patients’ discharge. Data were analyzed using descriptive statistics, paired t-tests to compare expectations and perceptions, and analysis of variance to examine differences across socio-demographic groups. Results. Patients had positive perceptions of the provided services. The results indicated the existence of a gap between patients’ expectations and their perceptions of the services received. Mean expectations were high across dimensions (overall 4.85; range 4.79–4.88), as were perceptions (overall 4.90; range 4.85–4.94). All gaps were positive (perceptions > expectations). Dimension-specific gaps were as follows: tangibility 0.06 (p = 0.196), reliability 0.05 (p = 0.132), responsiveness 0.04 (p = 0.249), assurance 0.06 (p = 0.107), empathy 0.06 (p = 0.039). Only the empathy dimension reached statistical significance. No significant differences emerged across sociodemographic subgroups. Conclusion. The SERVQUAL method provided clear insights into patients’ perceptions of the quality of neurosurgical services. The findings from this study can contribute to improving service quality and increasing patient satisfaction, positively influencing clinical outcomes and the healthcare system as a whole.