Abstract The drainage of chronic subdural hematoma is a very frequently performed neurosurgical procedure. The management often requires subdurostomy with catheter placement for hematoma drainage. Sometimes, the catheter misplacement can lead to complications that could be catastrophic. This technical note introduces the Moscote–Agrawal guiding device, a tool designed to enhance the accuracy and safety of catheter placement during subdurostomy. We hope that this concept can be adapted by neurosurgeons around the world to minimize procedural risks, improve outcomes, and ensure the safety of neurosurgical practices.