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The state of the art of biological-machine systems integration (BMSI) with an emphasis on neural interfacing is reported. The goal of BMSI from a medical viewpoint is to effectively replace or facilitate activation of, or recording from, neural elements in a part of the nervous system. BMSI will be firstly examined from a generic level whereby the current technologies for noninvasive and invasive neural recording and neural stimulation will be detailed. A case study in the area of visual neuroprosthesis will be presented to elucidate the current and future issues facing BMSI. This will include a discussion on biocompatibility, design of stimulating electrodes, the implanted microelectronic neurostimulator, and parallelization of stimulus encoding and delivery.