Objective To explore the effect of goaldirected procedural sedation in neurosurgical ICU patients. Methods A total of 156 neurosurgical ICU patients were assigned into a control group of 80 and an intervention group of 76 according to their admission order, receiving either conventional sedation or goaldirected procedural sedation provided by a physiciannurse team. Results The intervention group had shorter length of ICU stay and lower incidence rate of adverse events related to sedation compared with the control group, and the satisfaction rate was higher than the control group (P<0.01 for both). Conclusion Implementation of goaldirected procedural sedation can effectively reduce adverse events related to sedation, shorten length of ICU stay, and enhance physician's and nurse's satisfaction with sedation.