Background: The integration of hybrid operation theatre into neurosurgical and neuroradiological routines is revolutionizing in particular the management of neurovascular emergencies, such as subarachnoid aneurysmal hemorrhage (SAH) or ruptured arteriovenous malformations. Results: The direct interaction between neurosurgeons and neuroradiologists in a joint environment changes and accelerates all diagnostic and therapeutic steps because all relevant procedures, including treatment control can be performed in a single room. Interventions of the skull base or the spine are also a domain of such hybrid theatre. Conclusion: As this new concept requires organisational changes throughout the entire patient management, a change of mindset is also needed at the institutional level in order to attain maximum benefits from such a setting.