Most published literature supports the use of ICP monitoring as a standard of care, though the benefit has never been conclusively proved by a prospective, randomized trial. Unfortunately, ICP monitoring is routinely performed in very few centers in India on a systematic basis. This is probably due to the common perception that it requires very sophisticated facilities and is prohibitively expensive for most patients. The author's institution was also faced with a comparable situation, and we have therefore developed a simple and economical system that is presented in practical detail. No custom-made equipment is necessary, and all disposables should be available in any hospital pharmacy. It is our hope that this will enable any center with an ICU for the management of neurosurgical patients to begin monitoring ICP. The system has been in consistent use for 3 years in our institution, and over 100 patients have been monitored successfully.