Precision medicine is “an innovative approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person” and has expanded from oncology to many other fields of medicine.1 Most clinical trials testing neurocritical care treatments have not been based on principles of precision medicine. Rather, they have used a “one-size-fits-all” approach. This has left us with largely neutral results regarding blood pressure (BP) management or surgical intervention for intracerebral hemorrhage, intracranial pressure (ICP) management in traumatic brain injury (TBI), and neuroprotection for ischemic stroke, TBI, and spinal cord injury.