The use of fast and accurate tools in critically ill patients for diagnosis and interventions with minimal or no risk to patients is widely validated.1-3 Extensive information is needed in neurosurgical practice on variants that can indirectly impact the clinical course of the patient. This can include alterations in cardiovascular system,1 gastrointestinal disorders, and kidney disorders, among others, for which the point-of-care ultrasound (POCUS) is useful and accessible in critical care services.3 Ultrasonography facilitates and guides procedures such as thoracentesis or central catheter placement, making these procedures safer and predictable. Also, it provides us with useful information for diagnosis even from artifacts (BLUE protocol: bedside lung ultrasound in emergency), management of the patient with shock, and evaluating structures (RUSH protocol: rapid ultrasound in shock and hypotension), among others.2 For neurosurgeons, it is a useful tool to allow access to the cerebral parenchyma and blood flow through 2 available techniques: B-mode color-coded transcranial duplex and transcranial Doppler. These are safe, noninvasive, and low-cost methods to manage critical care patients.4 Besides, it offers a window to evaluate brain pathologies thanks to techniques that go beyond the limitation of bone density of the skull.1 Srinivasan et al5 reported the use of POCUS in hemicraniectomy, valuable to visualize intracranial cavity to identify and follow pathologies. The evidence suggests its use in specific clinical scenarios due to certain benefits. These benefits include cost, accessibility, real-time evaluation of the patient,1 bedside care,6 and the possibility of constant monitoring without being afraid of the accumulated risk of radiation or exposure to contrast media, which is observed in other alternatives in images.2 To guide clinicians in choosing initial tests for patients with cranial bypass failure, Pershad et al7 compared the skull computed tomography (CT), rapid sequence magnetic resonance imaging (fsMRI) of the skull, and measurement of the optic nerve sheath diameter (ONSD) by POCUS. In their results, they found that in children with a lower probability of cranial bypass failure before the test, the most appropriate initial option is ONSD by ultrasonography, since it provides greater diagnostic precision in detecting increased intracranial pressure.7 On the other hand, it is very useful in the management of hydrocephalus with ventricular bypass. Jokola et al8 recently reviewed POCUS-guided placement of ventriculostomy. On the other hand, if shunt fails, there is no noninvasive direct detection method that reliably evaluates cerebrospinal pressure.8 Aralar et al9 demonstrate the use of ultrasound to monitor the valve and its mechanics as a promising alternative to determine the surgical intervention of a previously monitored shunt. As well as in monitoring after decompressive craniectomy, ultrasound proved to be highly useful in measuring the diameters of the cerebral ventricles and deviation from the midline. Bendella et al10 compared ultrasound vs CT performed 24 h after the procedure while examiner was blinded to CT results.10 Other clinical scenarios described in the literature for POCUS include intracranial hematomas, midline deviation, measurement of intracranial pressure, stroke, vasospasm, and brain death.4 Czosnyka et al11 elegantly showed an estimation of intracranial pressure (eICP) with transcranial Doppler (TCD) using the following formula: eICP=ABPm(1−FVd/FVm)−14,where ABPm denotes mean arterial blood pressure, FVd denotes diastolic flow velocity, and FVm denotes mean flow velocity. Moreover, POCUS has changed the landscape of pediatric emergencies.12 Parri et al13 suggest that the POCUS performed in emergencies can identify with great precision the type of fracture and depth in the skull of children with local signs of trauma.13 This can provide us with pertinent information for the estimation of post-trauma brain injuries in children under 2 yr. Despite CT being the gold standard for the diagnosis of foreign bodies in the pediatric population, there is evidence that indicates that POCUS could be more useful for objects with low radiopacity.14 In addition, it is portable and can be transferred to the bed of the patient, even on the critically ill.12 There are sufficient reasons for emergency personnel to use this technology for diagnosis of a foreign body at the ocular, gastrointestinal, and pulmonary levels, and subsequently guide themselves for removal; however, for neurosurgical purposes, it has limited utility in foreign bodies.14 Additionally, it has been shown that by incorporating POCUS early and frequently in emergency diagnostic protocols, it, directly and indirectly, reduces the costs associated with diagnostic tests, so that in addition to clinical benefits, it represents additional economic benefits.15 However, it should be mentioned that POCUS does not replace the need for other diagnostic tools,2 and more research is needed to establish more clearly the cases where it is most indicated.15 Funding This study did not receive any funding or financial support. Disclosures The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.