The present invention is an apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach. The apparatus includes a pulsed electric field generator and at least one electrode electrically coupled to the pulsed electric field generator. The electrode is configured for intravascular delivery, and extravascular placement, via an intra-to-extravascular approach. The electrode is configured for extravascular delivery of a pulsed electric field to induce neuromodulation.