In the article the author tries to generalize all cases of trepanation among Sarmatians tribes of Eurasia, he discusses paleoanthropological materials from territories of Azerbaijan, Volga region, Don region, Kazakhstan, Hungary, Romania. The first case of trepanation among Sarmatians was pointed out by D.G. Rokhlin in the Don Region of Russia. It dates back to the III-I centuries BC. The operation was luckily finished. Hungarian anthropologists studied 6 cases of trepanation among Sarmatians. All these cases are dated II–III centuries AB. The first cases were studied by a Hungarian anthropologist L. Bartucz. In three cases trepanations had been made in therapeutic purposes (Szentes-Kistoke, Hevizgörk, Zákányszék-Zákánydűlő), in one case (Csengele) it was post mortal (symbolic). Trepanation methods were grooving and cutting. From Oltenica necropolis in Romania we know about one case of perforation. We know about one case of trepanation in Peregruznoe I necropolis in the Volga Region. It was a post mortal symbolic trepanation made with boring method. One case of medical trepanation which is dated VI–IV centuries BC is known from Buldura I necropolis in West Kazakhstan. The author of this paper studied 3 cases of trepanation on the territory of the Azerbaijan Republic. One case of symbolic trepanation was found in Mingechaur in a burial of Catacomb culture of Azerbaijan, which dates back to the I–VII centuries AB. A perforation hole has an oval form. The method of trepanation is cutting. The second case of trepanation from Azerbaijan was found in the Sheki Region. It was a ritual trepanation with cutting technique which was made in an artificially deformed skull. This skull has traces of probable scalping. Scalping is found among Sarmatian tribes of the Don Region too. The third case of trepanation among Sarmatians from Azerbaijan was found in Sandigtepe V necropolis in the Guba Region and dates back to the IV–V centuries AB. An artificially deformed female skull was perforated with cutting method. The burr hole is of a circle form. All cases of trepanation from Azerbaijan have a symbolic (ritual) character. There are 13 cases of trepanation among Sarmatian tribes of Eurasia at present days in total. Sarmatians practiced both symbolic (ritual) and medical trepanation. Probably, traditions of trepanation among Sarmatians have their origins in the influence of the ancient medicine. As to symbolic (ritual) trepanation, it can be related with the influence of nomads of East Eurasia.