Urgent reversal of anticoagulation in patients on warfarin therapy for neurosurgical procedures can be quite tricky as well as risky. Anticoagulation reversal using blood products has its own challenges and their administration must be guided with effective, investigative tools such as international normalized ratio (INR) and point-of-care coagulation tests. However, the superiority of either in neurosurgical procedures has not been established. Hence, a careful risk calculation must be done considering the overall clinical picture of the patient as well. We present a case report in which we faced such a dilemma.