As a physician assistant working in neurosurgery, you will be required to rapidly diagnose, provide initial nonsurgical management, and guide surgical treatment recommendations, all while working in a multidisciplinary setting. Neurosurgical emergencies require rapid assessment, and often intervention, to ensure optimal outcomes and prevent permanent neurologic deficits or death. This chapter will provide a brief overview of frequently encountered clinical presentations and surgical emergencies to provide you with the knowledge to confidently provide care in a high acuity setting.