 Traumatic brain injury is a leading cause of death and disability, beyond the severity of the initial injury. Secondary injury, due to molecular or inflammatory responses and worsening cerebral ischemia, strongly influences patient outcome. Minimizing secondary injury requires effective neural monitoring to guide the timing and type of therapeutic intervention provided. Numerous variables can be monitored, however, and those that should influence treatment decisions aren't clear. Now, an extensive literature review has examined the strengths, weaknesses, and treatment thresholds for various neural monitoring methods, providing information that might improve patient's neurologic outcomes after traumatic brain injury. Management of traumatic brain injury requires assessment of several variables associated with secondary injury. These include intracranial and cerebral perfusion pressures, brain oxygen levels, and cerebral metabolism. Alone, none of these elements comprehensively portrays the spectrum of pathophysiological changes occurring after traumatic brain injury, but tracking them together through so-called multimodal monitoring gives a fuller picture of the injured brain. Monitoring of intracranial pressure and cerebral perfusion pressure is a routine component of traumatic brain injury management in many centers. Keeping a patient's cerebral perfusion pressure within an optimal range, rather than using a generic threshold, is central to avoiding the risks associated with values that are too high or too low. One way to obtain an individual's target cerebral perfusion pressure range is by monitoring cerebral auto-regulation. Although intracranial pressure and cerebral perfusion pressure values are widely used to help manage traumatic brain injury, neither variable describes the adequacy of cerebral perfusion, an important factor when managing an injured brain. Indeed, cerebral ischemia frequently occurs even when intracranial pressure and cerebral perfusion pressure are within normal limits. But monitoring cerebral oxygenation along with pressure informs on the balance between oxygen delivery to and utilization by the brain, which can produce superior outcomes. Energy dysfunction is another key factor in traumatic brain injury pathophysiology that is not identified by routine neuromonitoring. Cerebral microdialysis can assess markers of cellular processes associated with glucose metabolism, oxygen supply, and cellular energy failure. Although high-quality evidence confirming that neuromonitor-guided interventions improve patient outcomes as needed, focusing on the interactions between different neuromonitoring variables could enhance personalized treatment. Understanding how to interpret combinations of different monitoring strategies is a promising step in this direction.