Neuroscience intensive care unit nurses routinely perform oral care on patients with intracranial pressure (ICP) monitoring. When the ICP is elevated or rises in response to oral care, this intervention may be withheld despite the lack of evidence linking the two. To appraise the best evidence for providing oral care to patients with ICP monitoring, articles published in English from 1978 to 2009 and indexed in CINHAL, PubMed/MEDLINE, Cochran Library, and BioSys were searched using the key terms ICP monitoring, intracranial hypertension, oral care, mouth care, hygiene, nursing interventions, nursing care, intensive care, and critical care. Reference lists of retrieved articles were reviewed for articles missed during the initial search. The search yielded 65 articles: 16 experimental or quasi-experimental studies, 24 descriptive studies, and 25 review articles. Of these, only four specifically tested or described the effect of oral care on ICP. There is a need for more knowledge about the effect of oral care on ICP so that evidence-based oral care practices in this patient population can be defined.