Objective To systematically integrate the best available evidence on analgesia and sedation management for neurocritical care patients, and to provide an evidence-based foundation for clinical practice. Methods According to the “6S” evidence pyramid model, a top down systematic search was conducted in repositories and websites including UpToDate, BMJ Best Practice, NICE, etc. Clinical decision, guidelines, evidence summary, systematic reviews, and expert consensus reports related to sedation and analgesia in neurocritical care patients published up to September 2025 were included. The quality of the included literature was assessed, and evidence was extracted. The 2014 JBI evidence pre-grading system was used for evidence grading. Results A total of 16 publications were included, comprising 1 clinical decision, 1 best practice report, 7 guidelines, 3 expert consensus reports, and 4 systematic reviews. Thirty pieces of evidence were summarized, covering six key themes: establishment of multidisciplinary teams, assessment and monitoring, implementation strategies, medication weaning and withdrawal, management in special situations, and quality improvement. Conclusion The summarized best evidence on sedation and analgesia management for neurocritical care patients, can provide evidence-based support for clinical staff to systematically and standardly manage analgesia and sedation in this population. Medical staff should integrate clinical context when applying evidence and evaluate the applicability of the best evidence from multiple perspectives.