Monitors of neurological function have been available since the 1950s. Until recently, however, many have remained in the hands of enthusiasts at academic centres. Many laboratory methods are not readily adaptable for intraoperative use or cannot be practically used routinely because of cost or the need for expert interpretation. The invasive nature of other monitors (e.g. cerebral microdialysis) precludes their use in the setting of systemic anticoagulation. Emerging evidence suggests that modern neuromonitoring technologies – particularly when used together – can be used both to predict and to modify clinical outcome.