The diagnosis of motor neuron disease (MND) remains a clinical one supported by EMG examination and exclusion of other conditions that may mimic MND. In a typical advanced case the clinical features are easy to recognise as they are almost pathognomonic (combination of upper and lower motor neuron features involving multiple body regions, appendicular and bulbar muscles). However, the diagnosis is more difficult in the early stages as the disease usually starts in one region then spreads within months to involve other regions which invites a large list of differential diagnosis. This may result in misdiagnosis or failure to exclude potentially treatable conditions, which may present with similar symptoms. Several diagnostic criteria have been developed namely the El Escorial, Awaji and WFN criteria. This audit intended to explore the neurodiagnostic practices in different neurophysiology departments throughout the U.K. that are used for the diagnosis of this devastating illness. The aim is to try and establish a standard electrodiagnostic approach suitable for the clinical presentation and the wide symptomatology of MND that would help to avoid misdiagnosis of this condition and exclude potentially treatable disorders which mimic MND.