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Microdialysis enables the chemistry of the extracellular interstitial space to be monitored. Use of this technique in patients with acute brain injury has increased our understanding of the pathophysiology of several acute neurological disorders. In 2004, a consensus document on the clinical application of cerebral microdialysis was published. Since then, there have been significant advances in the clinical use of microdialysis in neurocritical care. The objective of this review is to report on the International Microdialysis Forum held in Cambridge, UK, in April 2014 and to produce a revised and updated consensus statement about its clinical use including technique, data interpretation, relationship with outcome, role in guiding therapy in neurocritical care and research applications., We gratefully acknowledge financial support for participants as follows: P.J.H.-National Institute for Health Research (NIHR) Professorship and the NIHR Biomedical Research Centre, Cambridge; I.J. Medical Research Council (G1002277 ID 98489); A. H.-Medical Research Council, Royal College of Surgeons of England; K.L.H.C.-NIHR Biomedical Research Centre, Cambridge (Neuroscience Theme; Brain Injury and Repair Theme); M.G.B.-Wellcome Trust Dept Health Healthcare Innovation Challenge Fund (HICF-0510-080); L. H.-The Swedish Research Council, VINNOVA and Uppsala Berzelii Technology Centre for Neurodiagnostics; S. M.-Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico; D.K.M.-NIHR Senior Investigator Award to D.K.M., NIHR Cambridge Biomedical Research Centre (Neuroscience Theme), FP7 Program of the European Union; M. O.-Swiss National Science Foundation and the Novartis Foundation for Biomedical Research; J.S.-Fondo de Investigacion Sanitaria (Instituto de Salud Carlos III) (PI11/00700) co-financed by the European Regional Development; M.S.-NIHR University College London Hospitals Biomedical Research Centre; N. S.-Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico.