The central nervous system (CNS) remains a top priority in all medical interventions, including cardiac surgery, where its optimal care during the postoperative period is critical. Ensuring a safe recovery, particularly when patients are not fully awake due to residual anesthetics, sedatives, or analgesics, requires effective cerebral monitoring. CNS monitoring encompasses a wide range of techniques, from clinical assessments and scoring systems to advanced invasive and noninvasive technologies. While some of these monitoring tools are not yet standard for all cardiac surgery ICU patients, their use is increasingly advocated. This trend is driven by the growing number of high-risk patients—particularly the aging population—and rapid advancements in microprocessor technology, which have become integral to modern medical practice. For certain cardiac surgery patients, employing multiple monitoring modalities, known as “multimodal CNS monitoring,” is recommended. Recent guidelines and statements on CNS monitoring modalities have emerged, some of which are explored in this chapter.