Since the N-methyl-D-aspartate receptor (NMDAR) subunits were first cloned less than two decades ago, a substantial amount of research has been invested into understanding the physiological function of NMDARs in the healthy CNS and their pathological roles in a variety of neurological diseases. These include conditions resulting from acute excitotoxic insults (e.g. ischemic stroke, traumatic brain injury), diseases due to chronic neurodegeneration (e.g. Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis), disorders arising from sensitization of neurons (e.g. epilepsy, neuropathic pain), as well as neurodevelopmental disorders associated with NMDAR hypofunction (e.g. schizophrenia). There has been much focus on selective NMDAR antagonists which have not produced positive results in clinical trials. However, there are other NMDAR-targeted therapies used in current practice which are effective for treating certain neurological disorders. In this review, we describe the evidence for the use of these therapies and provide an overview of drugs being investigated in clinical trials. We also discuss novel NMDAR-based strategies which are emerging in clinical neurology.