Does monitoring intracranial pressure improve survival in traumatic brain injury (TBI)? The BEST-TRIP landmark trial explored the effectiveness of intracranial pressure (ICP) monitoring in improving outcomes among patients with severe TBI. A total of 324 patients with severe TBI were randomized to either receive ICP monitoring or standard clinical management without ICP monitoring. The study found no significant difference in mortality or functional outcomes between the two groups, suggesting that ICP monitoring did not confer a clear survival advantage. Despite its widespread use, the results of this trial raised questions about the utility of routine ICP monitoring in TBI management, challenging long-held practices in neurocritical care.