Neurological emergencies are a frequent presentation and often times with devastating short and long term consequences. There is paucity of data on adult neurological emergencies in Nigeria. The profile of patients with neurological emergencies has not been reported in our hospital. A retrospective study of neurological patients attending the emergency department was performed over a one- year period. Neurological emergencies accounted for 25.7% (284) of the total medical emergencies. The most common diagnoses were stroke (52.5%), meningoencephalitis (11.3%) and hypertensive encephalopathy (7.0%). Majority of the neurological patients were males, constituting 56.7%. Neurological emergencies were found to be common in the emergency room. There is need for the establishment of a specialised neurological emergency unit in the emergency department.