An anaesthetic/sedative agent will proceed to evaluation of neuroprotective efficacy in a clinical trial when two major prerequisites are fulfilled: first, a body of preclinical evidence for its neuroprotective effects is necessary, second, circumstantial information from human use must be available. While testing of many promising drugs does not proceed past the stage of demonstrating neuroprotection in the physiology laboratory, in 1999, the FDA approved the α2-adrenoceptor agonist dexmedetomidine (DEX) for use in humans for analgesia and sedation [1]. However, although DEX is increasingly being used in the care of neurosurgical patients [1]–[3], its neuroprotective effects were not evaluated in a patient trial. In the present article, we will therefore outline the current understanding of DEX-mediated neuroprotection, and compare this state of knowledge with key criteria for the design of a clinical trial by experts in the field of anaesthetic neuroprotection [4], [5].