This chapter discusses about the raised intracranial pressure in children with an acute brain injury: monitoring and management. Children with acute brain injury due to various neurologic and non-neurological illnesses commonly develop raised intracranial pressure (ICP). The aim of clinicians treating a child with raised ICP is to break the vicious cycle of cerebral edema and compromised cerebral blood flow (CBF) at the earliest and to maintain adequate cerebral perfusion pressure (CPP). Cerebral physiology and intracranial dynamics, pathophysiology related to raised intracranial pressure, etiology of raised intracranial pressure, assessment and monitoring of ICP, general measures intracranial hypertension, intracranial pressure monitoring, management of raised intracranial pressure, measures for refractory raised intracranial pressure are also discussed in this chapter.