To assess the appropriateness of surgical antibiotic prophylaxis in neurosurgical procedures, using the American Society of Health-System Pharmacists (ASHP) guideline as reference, 110 patients were prospectively evaluated. Monitoring surgical antibiotic prophylaxis is crucial in ensuring appropriate use of antimicrobial agents in this setting. This will minimize the consequences of antibiotic misuse such as increased drug antibiotic resistance, adverse events, and higher costs to the institution.