Cerebral vasospasm following an endoscopic endonasal resection of a craniopharyngioma is a rare, devastating occurrence that can lead to delayed cerebral ischemia and a poor neurological outcome if not diagnosed and treated in a timely manner. The etiology of this condition is not well understood. In this chapter, we present a case of cerebral vasospasm following transsphenoidal surgery (TSS) for craniopharyngioma, review the literature, and identify common presenting symptoms, probable predisposing factors, and essential management strategies to treat this condition.