Over the past century, advances in neuroimaging and cognitive neuroscience reshaped how we understand psychiatric disorders, expanding the portfolio of evidence-based treatments while routine clinical practice has mostly relied on trial and error. Precision medicine has steadily extended to psychiatry, and today we can target specific cortical or subcortical brain regions within defined pathological circuits to individualize treatments to particular symptoms. Neuromodulation sits at the frontier of this shift in psychiatry, with extensive ongoing research to identify optimal treatment targets and protocols personalized to individuals’ neural circuitry.