Neil Curtis was a new intern doctor on staff at the hospital when he asked Dr. Greg Peters to join his practice. Neil was also a compulsive gambler, and when his debts began to mount he proposed to a wealthy Amanda Howard. Amanda accepted, but on the night they were to marry she found him in bed with a prostitute. Amanda then attempted to commit suicide, but failed. Neil and his partner Greg Peters would eventually fight over Amanda. Neil would attempt to go to gamblers anonymous, but he was not set on recovering. With rising debits Neil proposed marriage to the wealthy Phyllis Anderson. Phyllis did love Neil, but insisted he sign a prenuptial agreement before marriage. In 1976 Neil would learn that Amanda Howard still loved him, but she had a brain tumor and was given six months to live. Amanda was afraid to undergo surgery because her mother had died from the same operation. Neil and Greg Peters eventually encouraged her to have the surgery, and as a result she lost her temporarily lost her memory and was unsure who she loved. Neil stepped aside and encouraged Amanda to pursue a relationship with Greg because he was already married. Later in 1976 Phyllis became pregnant, but attempted to have an abortion when she thought Neil didn't want the child. Phyllis was told she was too far along to have an abortion, and attempted to overdose on pills when Neil found her. However Phyllis would eventually lose the baby while trying to pick up a drunken Neil one night. The baby was born prematurely and died a few days later.

In 1978 Linda Patterson Anderson began to have an affair with Neil, but later broke it off. In 1980 Neil met and fell in love with Liz Chandler, however he was forced to break his relationship off with her when Kellam Chandler disapproved of the relationship. After losing Liz Neil continued to gamble and sank himself deeper in debt. In 1981 Maggie and Mickey decided to have a child. Maggie went to Neil and agreed to be inseminated by an anonymous donor. Neil preformed the procedure, and Maggie soon became pregnant. Later that year Dr. Evan Whyland came to Salem, and Neil knew he was the anonymous donor of Maggie's. In 1982 Neil and Liz tried to pursue a relationship, but it was put to an end when Tony refused to give Liz a divorce. Later Stefano planted a bomb in Neil's room, but Neil survived the blast and vowed to make the DiMera's pay. In 1982 when Liz became pregnant Neil realized the baby could be his. Neil tried to continue a relationship with Liz, but she pushed him away because she still feared for him life. Rejected, Neil sought comfort in the arms of Marie Horton. In 1983 Neil married Marie Horton. Even though Neil married Marie, he still continued to love Liz. When Neil came home and found Liz in his bed he was angry, but then professed his love for her and to two made love. Neil was then called to the hospital, and Liz would eventually shoot Marie, who she thought was a burglar. Liz was arrested and sentenced to serve five years in jail. Shortly after Marie was shot she and Neil divorced.

Neil and Liz planned to marry while she was in prison, but during the wedding there was a prison break and Liz was shot. Liz was released from prison in 1984 on parole, but she still had amnesia. When she tried to holdup Doug's place her memory came flooding back at the site of a gun, when she flash backed to Marie's shooting. Later that year Liz and Neil were married. In 1984 Neil accused Liz of having an affair with Carlos Forenza. Liz had not had an affair, but his constant accusations and spying sent her into his bed fir a one-night stand. Neil and Liz made up, but he told her that in his past he used the alias Alan Jackson and owed a large sum of money to a crime boss. Carlos was out to destroy Neil, because Neil and his father turned state's evidence to keep out of prison. Mario died, and Carlos was out to avenge his father's death by destroying Neil. When Neil and Liz tried to flee Salem they were confronted by Carlos. Neil and Carlos fought, and in the process Neil accidentally shot Carlos with his own gun. As a present Neil bought Doug's place and renamed it Blondie's as a gift to

In 1989 Neil married the pregnant and extravagant Angelica Deveraux. Victor Kiriakis was furious that Angelica had not married him and he plotted to ruin Neil's marriage to her by luring him back into gambling. Neil eventually went into debt and had to sell Blondie's. Angelica quickly left him when he was near broke. Neil Curtis began a torrid love affair with Maggie Horton in 1990. Maggie's daughter, Sarah, caught Maggie and Neil and took pictures of them together in bed. Sarah was ready to expose them when Maggie and Neil revealed a shocking secret to her, Neil was Sarah's true father. Sarah still exposed them and the news devastated her adopted father, Mickey. Though Mickey was hurt, he felt he was partly to blame for Maggie's infidelity. Mickey and Maggie patched up their marriage and Dr. Neil Curtis left Salem.