Intracranial pressure monitoring is an essential element of severe head injury monitoring. In the Italian reality, this monitoring still has not become diffusely utilised. In this paper are analysed, using the available data obtained from the Neurolink database, the information from the more advanced Italian neurotrauma centres. Only 50% of the patients, in which monitoring is indicated, are monitored. Synthetically will be reviewed the indications to the monitoring, the advantages offers from such procedure, the modalities of monitoring considering also the economic impact and the risks legacies to the procedure.