Neuro-oncologic patients are at high risk for many adverse events, and the severity of these events varies greatly. While some may only require monitoring in the neurointensive care unit (NCCU), others may be lethal if intervention is not performed immediately. Furthermore, some patients may be admitted with signs of neurologic pathology but have no known oncologic history. Rapid evaluation and diagnosis of these patients is vital in order to prevent the mortality and morbidity associated with neuro-oncologic emergencies. This allows the NCCU team to deliver the most effective treatments and to push for better patient outcomes. This chapter summarizes the presentation, hospital course, and management of four of the most common neuro-oncologic emergencies, including elevated intracranial pressure, pituitary tumor apoplexy, acute tumor hemorrhage, and status epilepticus.