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Neuromonitoring with the microdialysis technique is now being utilized at the bedside. Cerebral metabolism monitoring enables identification of clinical events hours or even days before clinical examination changes, providing clinical staff an opportunity for earlier intervention. Cerebral microdialysis also allows clinicians to evaluate the impact of therapeutics on cerebral metabolism and certain metabolic patterns, which can trigger specific alerts and/or clinical protocols. Cerebral metabolism monitoring through microdialysis can guide clinicians to institute therapeutic measures that prevent the occurrence of secondary injury. This article focuses on the state-of-the-art application of cerebral microdialysis, the rationale for its use, and the nursing implications of this technique.