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Abstract Purpose The NeuroDiscovery AI database is a comprehensive real-world data (RWD) repository containing de-identified electronic health record (EHR) data from U.S.-based neurology outpatient clinics. The structured data encompasses sociodemographic details, clinical examinations, social, medical, and lifestyle histories, International Classification of Diseases (ICD-9/ICD-10) diagnoses, and prescribed medications. Additionally, the database integrates neuroimaging data and laboratory results, providing a robust resource for clinical research. This paper describes a subset of the NeuroDiscovery AI dataset and outlines the processes involved in its development. Participants As of October 15, 2024, the dataset includes EHR data from 355,791 patients, of whom 40.72% are male. Over 40.06% of the patients are aged 60 or older, spanning across 14,797 distinct diagnosis codes. The data represents more than 15 years of longitudinal patient information, with 26.87% of patients classified as active (defined as having had clinical encounters within the last 18 months). The median follow-up duration for active patients is 19.54 months. Limitation The large sample size, rigorous data processing, and robust data security of the NeuroDiscovery AI dataset are key strengths, enabling comprehensive studies on disease progression, treatment responses, and long-term outcomes in neurology. The dataset aligns closely with published demographic trends for various neurological conditions, including a female predominance in migraines, multiple sclerosis, and vertigo, with slight variations in age and gender distribution for conditions such as ALS. However, challenges remain, including missing data and data heterogeneity. Ongoing efforts to expand and diversify the dataset aim to improve its applicability and representativeness. Future plan The NeuroDiscovery AI dataset will expand by incorporating data from more providers and improving diversity, aiming to become one of the largest neurology-focused datasets. The platform will continue to evolve into a comprehensive analytical tool, integrating cohort building and data interrogation functionalities to streamline clinical workflows. These enhancements will enable faster, more accurate decision-making, and future efforts will focus on identifying key trends in neurological conditions and patient outcomes.