There are a variety of surgeries where IONM is indicated and its use supported by the scientific literature. And there are some surgical procedures that should not be attempted without monitoring. The list of surgical procedures where IOM is indicated or may be highly useful include:

• surgery of the aortic arch, its branch vessels, or thoracic aorta, including carotid artery surgery, when there is risk of cerebral ischemia resection of epileptogenic brain tissue or tumor
• resection of brain tissue close to the primary motor cortex and requiring brain mapping
• protection of cranial nerves: tumors that affect optic, trigeminal, facial, auditory nerves, cavernous sinus tumors, microvascular decompression of cranial nerves, oval or round window graft, endolymphatic shunt for Meniere's disease,- vestibular section for vertigo
• correction of scoliosis or deformity of spinal cord involving traction on the cord
• protection of spinal cord where work is performed in close proximity to the cord as in the placement or removal of old hardware, or where there have been numerous interventions
• spinal instrumentation requiring pedicle screws or distraction
• decompressive procedures on the spinal cord, or cauda equina carried out for myelopathy or claudication where function of spinal cord or spinal nerves is at risk
• spinal cord tumors
• neuromas of peripheral nerves of brachial plexus, when there is risk to major sensory or motor nerves
• surgery for intracranial AV malformations
• surgery for arteriovenous malformation of spinal cord
• cerebral vascular aneurysms
• surgery for intractable movement disorders
• arteriography, during which there is a test occlusion of the carotid artery
• circulatory arrest with hypothermia [does not include surgeries performed under circulatory bypass (e.g., CABG, ventricular aneurysms)]
• distal aortic procedures, where there is risk of ischemia to spinal cord
• leg lengthening procedures, where there is traction on sciatic nerve or other nerve trunks
• basil ganglia movement disorders
• surgery as a result of traumatic injury to spinal cord/brain
• deep brain stimulation