Neurosurgical patients are prone to acquired infectious diseases due to a variety of factors such as indwelling catheters， long-term bedridden， and low resistance， leading to a poor prognosis. Traditional pathogen detection methods take a long time to detect pathogens and have a low positive rate， making it easy to delay treatment. As a method of detecting pathogens， metagenomic next-generation sequencing（ mNGS） is characterized by fast detection speed and high sensitivity， which can effectively detect pathogens and provide clinicians with a basis for antibiotic use. This paper analyzes the effectiveness of mNGS in the diagnosis and treatment of acquired infectious diseases in neurosurgical patients， with a view to providing a reference for the future treatment of acquired infectious diseases in neurosurgical patients.