To evaluate the clinical necessity, outcomes, safety, and indications of contemporary combined pallidotomy and thalamotomy for Parkinson's disease (PD) with intractable tremor. The UPDRS data from 20 patients who received simultaneous pallidotomy and thalamotomy were analyzed retrospectively. During the same period, 326 patients were subjected to unilateral pallidotomy. Improvement and complications between the two groups were compared. Contemporary pallidotomy and thalamotomy effectively improved parkinsonian symptoms as did pallidotomy alone. This procedure completely abolished intractable tremor in all 20 patients. No permanent complications occurred. Contemporary combination of pallidotomy and thalamotomy is effective and safe in treating regular parkinsonian symptoms and intractable tremor.