The glymphatic system, discovered in 2012, plays a crucial role in the clearance of interstitial waste and the dynamics of cerebrospinal fluid (CSF) in the brain. This scoping review synthesizes current literature on the glymphatic system's role in neurosurgical conditions and its potential as a therapeutic target. Studies were selected from PubMed and Scopus databases, focusing on both animal and human studies published between 2012 and 2023. The review covers conditions such as idiopathic normal pressure hydrocephalus (iNPH), idiopathic intracranial hypertension (IIH), subarachnoid hemorrhage (SAH), stroke, intracranial tumors, and traumatic brain injury (TBI). Key findings include significant glymphatic dysregulation in iNPH and IIH, impaired CSF dynamics, and delayed clearance. SAH studies indicate glymphatic dysfunction with potential therapeutic effects of nimodipine and tissue plasminogen activator. In stroke, altered glymphatic activity correlates with edema and neurological recovery. TBI studies highlight the glymphatic system's role in post-injury cognitive outcomes. The regulation of aquaporin-4 (AQP4) channels is identified as a critical therapeutic target. While promising, further human studies are needed to translate these findings into clinical practice. Future research should focus on establishing non-invasive biomarkers for glymphatic function and exploring long-term effects of glymphatic dysfunction.The glymphatic system, discovered in 2012, plays a crucial role in the clearance of interstitial waste and the dynamics of cerebrospinal fluid (CSF) in the brain. This scoping review synthesizes current literature on the glymphatic system's role in neurosurgical conditions and its potential as a therapeutic target. Studies were selected from PubMed and Scopus databases, focusing on both animal and human studies published between 2012 and 2023. The review covers conditions such as idiopathic normal pressure hydrocephalus (iNPH), idiopathic intracranial hypertension (IIH), subarachnoid hemorrhage (SAH), stroke, intracranial tumors, and traumatic brain injury (TBI). Key findings include significant glymphatic dysregulation in iNPH and IIH, impaired CSF dynamics, and delayed clearance. SAH studies indicate glymphatic dysfunction with potential therapeutic effects of nimodipine and tissue plasminogen activator. In stroke, altered glymphatic activity correlates with edema and neurological recovery. TBI studies highlight the glymphatic system's role in post-injury cognitive outcomes. The regulation of aquaporin-4 (AQP4) channels is identified as a critical therapeutic target. While promising, further human studies are needed to translate these findings into clinical practice. Future research should focus on establishing non-invasive biomarkers for glymphatic function and exploring long-term effects of glymphatic dysfunction.